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THE
WORKS
OF THE LATE
w
ILLUM STARK, M. D.
ST/\
t
T I-I E
WORKS
OF THE LATE
W I L L I A M STARK, M. D.
CONSISTING OF
CLINICAL and ANATOMICAL OBSERVATIONS,
WITH
EXPERIMENTS,
DIETETICAL and STATICAL,
REVISED and PUBLISHED from his ORIG.INAL MSS.
B Y
JAMES CARMICHAEL SMYTH, M. D. F.R.S.
PHYSICIAN EXTRAORDINARY to his MAJESTY.
LONDON:
Printed for J. JOHNSON, No. 72, St. Paul'* Church-Yard.
M.DCC, LXXXVI I I,
! Q 7 a
CrA-^oxA—
i j I lllill^.l |,ljii*wfi1il*lW^ffM*' ""** I " I "■
T 0>
The Hon. THOMAS FITZMiUJR I CE,
S I R,
A S mankind are commonly defirous of know-
ing the perfons to whom they are indebted, it is proper for me to
inform them, that if any ufeful knowledge is contained in the
following pages, they owe it chiefly to you. You diflinguiihed,,
at an early period of life, the talents and abilities of the Author ;
you honoured him with your friendship, encouraged him by your
protection, and your regard for his memory has preferved his
works from oblivion, which, otherwife, would have perifhed with
himfelf. You at firfr. committed them to the care of a Gentleman*
very capable to have done them juftice, had not bad health and
a variety of avocations, prevented him. For myfelf, I can only
fay, that I have executed, widi all the zeal and ardour of
friendship, a talk which I formerly undertook at the requefr. of the
Author, and to the performance of which I felt myfelf urged by
thole fentiments which are fo happily expreffed in the energetic
and
( iv )
and manly language of the firft of hiitorians. " Non hoc prascipuam
" amicorum munus eft, profequi defunclurn ignavb queftu ; fed qua?
" voluerit meminifTe; quae mandaverit exfequi*."
Permit me, Sir, to acknowledge Kkewife, the pleafure which this
oecafion affords me, of publickly declaring the great regard and
citeem, with which I have the honour to be,
S I R,
Your moft obedient,
And moft humble fervant,
JAMES CARMICHAEL SMYTH.
# Tacit. Annal. lib. ii? cap. Ixxi.
The
PREFACE by the EDITOR.
ALTHOUGH the importance and fcarcity of original
Obfervations in Phyfic are well known, yet I am ready
to confefs, that neither the merits or originality of the prefent
work, nor even my knowledge of the accuracy and candour of
the Author, would have been fufficient inducements with me to
become the Editor, had I not felt a ftrong defire to comply with
the requifition of a friend, now no more, and a wifh to preferve
to his memory, the fame he fo juftly deferves, and which he
fo dearly earned. It is evident that I was influenced by no
pecuniary motive, as any emolument arifing from the fale of the
book is deftined to his family; and I could expect but little re-
putation from publishing the works of another, compared with
the time and trouble which I mull neceffarily devote to it.
As Editor, my chief object has been perfpicuity ; and to effect
this, I have taken conflderable liberties both with the arrangement and
language of the Author ; adhering, however, with the moil fcru-
pulous exactnefs, to facts, and, wherever I could, retaining his
own language, which, though fometimes obfcure, is commonly
expreilive and manly. I am extremely fenfible that this mixture
of
VIII
PREFACE by the EDITOR;
of compofition mutt affect the unity and fmoothnefs of the flile,
but, in works of fcience, it is clearnefs and precifion, more than
elegance, that is wanted.
The different parts into which the Clinical and Anatomical
Obfervations are diftributed, though equally correct, are by no
means equally complete, or equally ufefui. It was, at firft, my
intention, to have endeavoured to fupply what appeared to me de»
fective, and to have fubjoined a comment to each part, in the
manner I formerly did to the one published in the Medical Com-
munications, but I foon found that I had neither time or leifure
atpreient, for fuch an undertaking. I mall therefore only obferve in
general, that from the Clinical and Anatomical Obfervations of
our Author, the young may receive much ufefui information,
and that even the more experienced may find fomething to
iearn.
His Experiments on Diet are the firft, and will probably long
remain the only Experiments of the kind. It will pofiibly be
objected to them, that they arc not fuiiiciently numerous or va-
ried to admit of any conclufions, bat I would advife thole who may
ftart fuch objections, to reflect, that all inductions from experi-
ence, are, at bell:, only greater or lefs de0rees of probability, and
that if one Experiment did not afford fome probability, twenty
Experiments could not eftablifh any. Eut Dr. Stark's Experi-
ments will be looked upon by all true lovers of fcience, in a
much higher point of view. They wili be confidered as the
corner-flone or a great building, to be finished at fome after-pe-
riod of time, when men fhall be found of equal fortitude, per-
feverance
PREFACE by the EDITOR. ix
Severance and felf-denial with our Author, actuated by a fimilar
zeal for the promoting of ufeful knowledge.
Having faid thus much of the Work, it may be expected that
I mould fay fomething of the Author himfelf. This I do with
a fingular pleafure, as it is tracing back in my remembrance, the
image of a friend I efleemed and valued, and to whom I am cer-
tain it would have afforded a fingular fatisfaction, had he known
that I would have been the publimer of his works, and the hif-
torian of his life.
Dr. Stark's father, as I have been told, was a native of Ireland,
his mother of Scotland, he himfelf was born at Birmingham.
This might be confidered as a whimfical anecdote only, and
fcarcely defer ving notice, did we not every day fee the characters
and conduct of men influenced by fuch trifling and accidental
circumftances, and therefore it may not be unreafonable to fuppofe,
that even this had fome effect in expanding the natural liberality
of his mind, and freeing it from all thofe little local and con-
fined prejudices, which too often difgrace characters otherwife
refpectable. But, wherever his cradle was rocked, he was educated
at Glafgow, and there, under Drs. Adam Smith, Black, Reid, &c.
he firft learnt the rudiments of philofophy, and acquired that
mathematical accuracy, that logical precifion, and fceptic doubt,
which diflinguifhed his future life.
From Glafgow he repaired to Edinburgh, where he was foon
diflinguifhed, and honoured with the friendship of Dr. Culleij,
who is not more eminently confpicuous for the fuperiority of his
b own
x PREFACE by tme EDITOR.
own genius, than quick-fighted in difHngui firing,, and liberal in-
encouraging it in others.
Having finifhed his fludies at Edinburgh, he came to London
in the year 1765, and now devoted himfelf entirely to the ftudy
of phyfic -, and, looking upon anatomy as one of the principal
pillars of the art, he endeavoured to complete with Dr. Hunter,
what he had begun with Dr. Monro, and acquired, under this
eminent profeffor, that perfect anatomical knowledge, which appears in
all his difTections. He likewife entered himfelf a pupil at St.
George's Hofpital -, and, difgufted, as he has often told me, with
the inaccuracy or want of candour, of the generality of practical
writers, he determined to obtain an acquaintance with difeafes
at a better fchool* and under mi abler mailer j and to have, from
his own experience, a ftandard, by which he might judge of the
experience of others- With what induffry he profecuted this
plan, and with what fuccefs his labours were crowned, we may,
form fome judgment from the fpecimen now offered to the Public.
Whilfl attending the hofpital, he was alfo employed in making
experiments on the blood, and other animal fluids; and like wife in
a courfe of experiments on chemical pharmacy, which are frill
extant, and give the ilrongefr evidence of his accuracy and dili-
gence ; but whether they are of importance enough to be prefented
to the public, I have not yet had leifure to afcertain.
In the year 1767, he graduated at Leyden, and published an;
Inaugural DhTerta'tion on the Dyfentery. On his return to London
he recommenced his ftudies at the hofpital -, and, in June, 1769, began
fail
PREFACE by the EDITOR. si
his Experiments on Diet, to which undertaking he was greatly encou-
raged by Sir John Pringle and Dr. Franklin, whofe friendfhip he
then enjoyed, and from whom he received many hints, both as to
the plan, and, afterwards, in the execution of his defign. Thefe
Experiments, or rather the imprudent zeal with which he profecuted
them, proved in the end fatal to himfelf; at leaf!, fuch was the
general opinion of his friends at the time, but, in my mind,* and I
fpeak from an intimate knowledge of his character, other caufes,
pa; ticularly chagrin and difappointment, had no fmall mare in
bringing about this event. Dr. Stark was much more converfant
with books than with men; poffeffing great flrmnefs and dignity of
mi xl himfelf, with uncommon fimplicity of manners, he was ill
prepared for the cold prudence, the time-ferving meannefs, or the
bafe duplicity which he met with in others. He had not yet
learned in the great fchool of the world, a leiTon which all young
and ingenuous minds receive at firft with indignation, viz. that
genius or talents avail nothing, when oppofed to intereft or to faction.
Nor had he yet made the obfervation of Figaro, equally applicable to
all ages and to ail countries,
Que, le iavoir fafre, vaut mieux que le favoir.
But if Dr- Siark may by fome be reckoned unfortunate, in having
been cut off at an early period of life, and before he had ob-
tained that eminence and diitinction to which his talents and
application entitled him, he was peculiarly fortunate in what is
infinitely more valuable. If his life was fhort, it had, at leail, been
fpent in the molt agreeable, as well as mod ufeful of all purfuits,
the purfuit of knowledge. If he did not accumulate wealth, he
preferved his independence. If he did not obtain the vain praife of
b 2 the
Xll
PREFACE by the EDITOR.
the world, he had the fuffrage of the wife and good, the praife
that's worth ambition. He enjoyed the high fatisfaclion, laudari
a laudatis viris, and a ftill higher fatisfaction, in the confciouf-
nefs of having always afted his part with integrity and honour;
and, in his laft moments, might have juftly confoled himfelf
with the magnanimous reflexion of the immortal Tycho, " non
inutilis vixi."
For thofe who wifh to know his perfon, I mall tranfcribe the
account he himfelf gives of it, at the beginning of his Experiments
on Diet. " The perfon," fays he, " upon whom thefe Experiments
are tried, is a healthy man, about twenty-nine years of age, fix feet
high, ftoutly made, but not corpulent, of a florid complexion, with
red hair."
The character of his mind, which is infinitely more valuable,
I mall not pretend to delineate; but thofe who were beft ac-
quainted with his merit, will not think, that I apply improperly
to him, what was formerly faid by Salluft, of one of the greatefr.
and beil of the Roman citizens — " Non divitiis cum divite, neque
faclione cum facliofo, fed cum ftrenuo virtu te, cum modefto pudore,
cum innocente abftinentia certabat; effe, quam videri, bonus ma-
kbat*M
* Bui. Catalin. cap. liv.
TABLE.
ABLE
O F
O N T E N
CLINICAL and ANATOMICAL OBSERVATIONS.
PART I.
Difeafes of the Stomach, Inteftines, and Liver.
CHAP I.
Difeafes of the Stomach illuflrated by Dijfeflion.
Page
i . Cancer in the Stomach -_ i
2. Inflam?nation of thefmaller Intejiines, with Effufon of Blood 2
3 . Blacknefs of the Cellular Subftance, a?zd Erofons of the internal
and neighbouring Coats of the larger Intejiines - 4
4. The glandular Follicles of the great Intejiines much enlarged,
and filed with a glutinous Sub/lance 5
5 Striclure
xiv CONTENTS.
Page
5 . Stricture in the Re'Bum, and Erojion of the Glands of the
Ileum ------ _ j
6. Irruption into the Colon of 'Matter , collected near the right
Hypochondrium ------ 8
j. .Numerous Conjlriflions of the Intsjlines 9
8. Hardnefs of the Liver, and Thi/inefs of the Bile - 10
9 . Abfcefs of the Liver - - - - 11
10. Hy da tides in the Liver ----- ibid.
1 1 . Whitiflj Granules, or Tubercles in the Liver - - 12
12. The Common Gall-due'* l J!:ut up by a Gallflone, and the He-
patic-dudl opening into the Duod.num - ibid.
CHAP. II.
A Dtfcription of the Symptoms of Difeafes cf the Stomach, &c.
taken from thoje Cafes where the Patients recovered, or where
the Author had no Opportunity of examining the Bodies
after Death.
1 . Vomiting - -----_j-,
2. Purging ----- - _ I4
3. Cojlivenefs - - - - - - - ir
4. Jaundice »---__*. j6
C H A P. III.
Obfervations on the Effects of Remedies, given in the Cure of
Dfeafes of the Stomach, &c. - - - 17
PART
CONTENTS. xv
PART II.
Difeafes of the Cbeft*
CHAP. I.
Difeafes of the Cheji Migrated by Difeclion,
Page
i » The Canal of the Aorta almojijhut up by the femilunar Valves 1 9
2. Pericardium adhering to the Heart - - 20
3. the Pericardium enlarge 'd, containing eight Ounces of a Flu-
id, and, by fatty Papilla, adhering partially to the Heart 2 1
4. "Ulceration of the Lungs, or Pulminary Confumption 22
Symptoms of the Difeafe - ibid.
Appearances on Difeclion - - 25
Tubercle - - - - 26
Vomica - - - 27
£&?/? c/V^ ^/r Vejfels aud Cellular Sub/lance - 2&
State of the large Blood VeJJels - - #/*/.
'Trachea - - - 29
!T/fo Degrees of morbid Affection - - $/<£.
5. ./£;* Aneurifm of the Pulmonary Artery opening into a Vomica 3 1
6. 7#<r Vefcles of the Lungs filled with extravafated Blood 32
7. Lymph in the Thorax - - - oc
8. Inflammation of the Pleura, and Efu/ion of Blood in the In-
tercoflal Mufcles - - - o£
9. Suppuration of the contiguous Surface of the Diaphragm
and Liver « - « ^7
CHAP,
-* I
XVI
CONTENTS,
CHAP. II.
A Defcription of the Symptoms of Difeqfes of the Chef, taken from
thofe Cafes where the Patients recovered, or where the Au-
thor had no Opportunity of examining the Bodies after Death
i. Of the different Kinds of Cough Page
Cough without Expectoration, or with Expectoration of
Mucus only - - -. - 38
Cough, with Expecloration of thick Matter - 39
Cough, with Blood fpit up in f mall Quantities - 40
Cough, with Blood f owing from the Mouth by Fits 41
A remarkable Inftance of Recovery from a violent Spitting
of Blood - 42
2. Of difficult Breathing, or Aflhma - 43
An In fiance of difficult Breathing relieved upon foft Tu-
mors appearing externally - *■ 44
A Cafe of difficult Breathing immediately relieved, by the
fpontaneous Dij charge of Matter from the Side 45
3. Of Pains in the Side - - - 46
CHAP. III.
Obfervations on the Effects of Remedies employed in the Cure of
Difeafes of the Chef - - - 47
PART III.
Difeafes of the Fluids.
CHAP.
CONTENTS.
CHAP. I.
XVII
Page
Difeafes of the Fluids, illuftrated by DiffeBion - 49
1 Extravafation of the Serum, or thinner Part of the Blood ibid.'
2 Extravafation of the red Part of the Blood 50
3 Extravafation of coloured Serum, &.c. - - 52
4 PutrefaBion of the Fluids, &c. - - "53
5 Extravafation and PutrefaBion, united in the fame SubjeB 55
CHAP. II.
A Defcription of the Symptoms of the Difeafes of the Fluids,
taken from thofe Cafes where the Patients recovered, or
where the Author had no Opportunity of examining the Bodies
after Death - 59
1 Swelling of the Belly, with FluBuat ion - - ibid.
2 General external Swelling, retaining the Imprefion of the Finger 60
3 General external Swelling, with Swelling of the Belly - ibid.
4 A fluBuating Swelling on the Loins - - 61
5 Fever, with red, or purple Spots on the Skin - - 6z
CHAP. III.
Obfervations on the EffeBs of Remedies given in the Cure of Dif-
eafes of the Fluids -
1 A general Account of thofe EffeBs - 64
c 2 The
xvlii CONTENTS,
Page
2 The Effect of Mercury in an cbjlinate Swelling of the Limbs 64
3 The EJ/'ecl of Barks in a copious Df charge of putrid Saliva 65
PART IV.
Difeafes of the Head, Nerves and Mufcles.
CHAP. I.
Difeafes of the Head, &t\ illuf rated by Diffeclion.
1 Lymph lodged 'between the Dura and Pia Mater - 68
•2 Suppuration of Part of the Dura Mater - - 70
3 The Veins of the Pia Mater apparently enlarged - 72
4 No morbid Appearance in the Brain after an Apoplexy 73
5 Deep red Blotches, and partial Suppuration in fever al Mufcles
of the Body, in confequence of a Wound - - 74
CHAP II.
A Description of the Symptoms of Difeafes of the Head, Nerves,
and Mufcles, taken from thofe Cafes where the Patients re-
covered, or where the Author had ?io Opportunity of examin-
ing the Bodies after Death
1 Lofs ofFee/ing and of Motion - 77
2 Lofs of Mot ion j with Relaxation of the Parts 79
3 Lofs
CONTENTS. xix
Page
3 Lofs of Motion > ivith Contraction of the Farts - - 80
4 Perpetual involuntary Motion - - « 82
CHAP. III.
Obfervations on the Effects of Remedies in Difeafes of the
Head, &c. - - - "84
BBMMM
EXPERIMENTS DIETETICAL and STATICAL.
EXPERIMENTS on DIET.
Introduction - - - - 89
Facts relative to Diet - - - 92
Obfervations on Digejlion - - - 94
Abjlract of a Journal kept during a Courfe of Experiments
on Diet - - - - 96
EXPERIMENT I.
Diet of Bread and Water - - - 96
c2 EXPERIMENT
Page.
xx CONTENTS.
EXPERIMENT II.
Diet of Bread and Water, with Sugar - - ioo
EXPERIMENT III.
Diet of Bread and Water, with Oil of Olives - 105
EXPERIMENT IV.
Diet of Bread and Water, with Milk - - 109
EXPERIMENT V.
Diet of Bread and Water, with roafled Gcofe - III
EXPERIMENT VI.
Diet of Bread and Water, with boiled Beef - - 114.
EXPERIMENT II. repeated.
Diet of Bread and Water, with Sugar - - 115
EXPERIMENT VI. repeated.
Diet of Bread, with boiled Beef and Water - 117
EXPERIMENT
CONTENTS
xxi
EXPERIMENT VII.
Page
Diet of Br end, with only the lean Part of boiled Beef and
Water - - - - 1 1 8
EXPERIMENT VIII.
Diet, Jlewed Lean of Beef with the Gravy, and Water 121
EXPERIMENT IX.
Diet, Jlewed Lean of Beef , with the Gravy, Oil of Fat or
Suet, and Water - - - -122
EXPERIMENT X.
Diet of Flour, Oil of Suet, Water, and Salt - - 124
EXPERIMENT XI.
Diet of Flour, Water, and Salt - » - 127
EXPERIMENT X. repeated.
Diet of Flour, Beef Suet, Water, and Salt « - J29
EXPERIMENT XII.
Dkt of Flour , frejh Butter, Water, and Salt, - 130
EXPERIMENT
xxii CONTENT S.
EXPERIMENT XIII.
Page
Diet, Yolks of Eggs, Suet, Figs, and Water. - - 131
EXPERIMENT XII. repeated.
Diet of Flour, Butter, or Oil of Butter, Water, and Salt 1 3 3
EXPERIMENT XIV.
Diet of Flour, Oil of Marrow, Water, and Salt. - 135
EXPERIMENT XV.
Diet irregular * ~ - - - ** 137
EXPERIMENT XVI.
Diet, Bread with roa/led Fowl, Infifion of Tea, and Sugar 139
EXPERIMENT XVII.
Diet, Bread, flcwed Lean of Beef, with the Gravy, Infufwn
of Tea, with Sugar - - - 141
EXPERIMENT XVIII.
Diet, Bread, the Fat offewed Beef with the Jelly, Water,
and Salt - - - - 144
EXPERIMENT
CONTENTS. xxiii
EXPERIMENT VII. repeated.
Diet, Bread } the Lean oj boiled Beef, Infufon of Tea, with
Sugar, but no Salt - - - - - 147
EXPERIMENT XIX.
Diet, Bread, Fat of boiled Beef, Infujion of Tea, with Sugar 150
EXPERIMENT XX.
Diet, Breaa, the Lean of roajied Veal, and Water * 153
EXPERIMENT XXI.
Diet, Bread, Fat of Bacon- ham, Infufon of Tea, with
Sugar - - - - 155
EXPERIMENT XXII.
Diet, Bread, Lean of Bacon-ham, Infujion of Tea, with
Sugar - - - - " lS7
EXPERIMENT XXIII.
Diet, Bread, or Flour, with Honey, and Infufon of Tea,
or ofRofemary - - - - 1 $g
EXPERIMENT XXIV.
Diet, Bread, with Chef dire Cheefe, and Infujion ofRofemary 165
STATICAL
xxiv CONTENTS.
STATICAL EXPERIMENTS.
Statical Experiments, or Ob/ervations made on the Weight of
the Body, with a View to determine how far it is af-
fected, both in the Day and Night, by the D if charges
of Perfpiration and Urine - - - 169
Statical Table - - - - 171
Account of Dr. Stark's laft Illnefs and Death - - 183
Mr. Hewfons Account of the DiJJetlion of the Body 185
Mr. Hunter s Account from Memory, fame Days after-
'Wards « - - m 189
CLINICAL
■ ■ »i ■! nr
CLINICAL and ANATOMICAL
OBSERVATIONS.
PREFACE
TO THE
CLINICAL and ANATOMICAL OBSERVATIONS.
IT is with the greateft: diffidence that the Author of the fol-
lowing work, though encouraged by the advice of fome very
gooi judges, ventures to prefent it to the Publick, but he flat-
ters himfelf, that in this enlightened age, when original obferva-
tions on difeafes are fo much, and fo juftly fought after, it
will be received, at leaft with indulgence, if not with approba-
tion.
The materials were collected at a large hofpital, where he had
at all times accefs to the lick, and, confeqnently, the mofl: fa-
vourable opportunity of obferving the appearance and progreis of
difeafes, and, when they proved fatal, of examining the bodies
after death. Pie employed feveral years in thefe refearches, deem-
ing it an indifpenfable duty to write a faithful hiftory of each
difeafe, from the report of the patient, and never deviating from
this rule, but where the lick were incapable of giving a fatis-
d 2 factory
xxviii PREFACE.
factory account of their complaints -, then, and then only, he had
recourie to the relation of friends, or of thofe who were prefent.
His remarks are the refult of ohfervation and infpection, unbi-
ased by any hypothecs or fyflem. He has made but little ufe
of the terms of art, from an opinion that they are not always
very correctly applied, and being defirous of avoiding all vain
parade of learning, or ground of cavil.
The parts into which this work are divided, are thofe into
which the materials feemed naturally to break themfelves, and
the order is according to their degree of fimplicity and certainty.
The firil place is given to difeafes of the alimentary canal ;
which, as moll within our reach, are probably the bed under-
itood, and the moft fuccefsfully treated.
Next to thofe of the alimentary canal, which converts our nou-
rimment into chyle ; are placed the difeafes of the heart and lungs,
which change the chyle into blood.
The third clafs comprehends the difeafes of the blood itfelf, and of
the fluids fecreted from it.
The fourth clafs includes the difeafes of the nervous fyflem, by
far the moil difficult to be underflood.
It was the Author's original intention to have added feveral
other claffes, particularly one giving an account of common fevers,
another on the difeafes of the urinary organs, and a third on the
diflempers
PREFACE. xxix
diftempers peculiar to women, but finding it a more difficult and
tedious labour than he at firft apprehended, to abridge diaries of
fingle cafes, and to place thofe which are fimilar, in the fame
point of view ; he is obliged to defer the execution of this part
of his plan to fome future opportunity.
The firfl chapter contains an account of thofe difeafes which
proved fatal, with the morbid appearances upon diffe&ion.
The fecond relates the bifiory of fymptotns only >y for when
the difeafe did not prove fatal, the morbid flate of the parts could
not be defcribed : and, in the prefent imperfect flate of the art,
however difcriminating fymptoms may be, they can only lead
to a probable conjecture of the condition of the difeafed parts. It
would be the perfection, indeed, of medical fcience, could we,
from the fymptoms alone, declare with certainty, the changes which
have taken place in the body, and thus, in many diforders,
have a truly rational foundation for practice. A frequent, care-
ful, and impartial comparifon of the fymptoms which have pre-
ceded death, with the appearances of the dead body, can alone lead
to this defirable perfection.
In the third chapter you have the fuppofed effects of medicines.
But in this matter, which is of the utmoft importance, we are
liable to great deception, As fymptoms, whether difeafes be left
to nature, or treated by art, are always changing, fometimes fa-
vourably, fometimes unfavourably, fo that it requires great faga-
city, diligent obfervation, and a thorough knowledge of difeafes,
to
xxx PREFACE.
to diftinguim between thofe changes which happen in the natu-
ral courfe of a diftemper, and thofe which are the effects of re-
medies applied -, yet, unlefs fuch diftinction be made, our opinions
with regard to the effects of remedies will be perpetually liable to un-
certainty. There is, perhaps, no place fo favourable for obtaining this
knowledge as an hofpital -, here we fee a number of fick, who,
from their circumftances and fituation, have not had it in their
power to prevent their diforders from taking their natural courfe ;
here, therefore, it is, that the foundation muff be laid of this
moft neceffary and important distinction, whereby numberlefs mis-
takes to which this fubject has always been liable, can alone be
obviated.
The examples which I have given of difeafes running on in
their natural courfe, and terminating favourably, which J call a
fpontaneous cure, will not, I hope, be ufelefs or uninfirudtive.
The delicacy which I am bound to obferve, when defcribing
the cafes of patients who were under the care, or relating the
effects of medicines prcfcribed by othei phyficians, obliges me to
mention thofe . medicines only which feemed fucccfsful. I am
very fenfible that filence, with refpect to the unfuccefsful cafes,
which mould be fairly compared with the fuccefsful, being the pro-
per method of conveying truth and conviction to the mind, is a
very great defect, but it was here unavoidable. I have, however,
endeavoured to fupply this deficiency, by relating, and I believe
impartially, the refult of a comparifon made by myfelf. But it
will not, I hope, be thought, from my filence refpeding feve-
ral remedies whofe effects appeared ambiguous, that I fuppofed
them t0 kc wholly inefficacious.
The
PREFACE. xxxi
The chapters are fubdivided into fections, which, in the firft
chapter, confift frequently of one or more cafes, the diffections
not having been fufficie'ntly numerous to admit of the fhorter,
and more eligible method of compofing from a number, one general
hiftory.
In the fecond chapter each article, or fection, is an attempt
towards a general hiftory of the difeafe or lymptom.
The third chapter is fometimes divided into fections, accord-
ing to the particular remedies, whofe effects are related.
The queries are thofe opinions or doubts, which a comparifon
of the fymptoms that preceded, with the appearances after death,
fuggefted to the author at the time ; and were deligned to direct
the attention of the Reader, to the moft important objects.
The difficulties which attend the execution of fo extenfive an
undertaking, comprehending all the diforders which come under
the care of a phyfician in a large hofpital, will doubtlefs plead
the Author's excufe with the candid, for the many imperfections
of this firft fketch, which, at leaft, has this merit, that it is
faithfully copied from nature. Of its numberlefs defects no per-
fon can be more fenfible than he is himfelf,. but he thinks it
better to fubmit it to its fate, rude and imperfect as it is, than
to fupply any thing from conjecture, that bane of phyfic and bar to
all improvement. Upon the whole, he trufts, that this performance,
however defective in itfelf, will anfwer one good purpofe, by point-
ing out a large hofpital as an inexhaustible fource of the moft ufeful
medical knowledge.
CLINICAL
CLINICAL and ANATOMICAL
OBSERVATIONS.
— g— ■ »— ■■■ i - — ■*■**-
PART I.
Difeafes of the Stomachy Inteftines> and Liver.
CHAP. I.
Difeafes of the Stomach, &c. illujlrated by DiJJecJion.
§ i. Cancer in the Stomach.
A
MAN, aged forty-five, was feized with a paJn ahnut the region
of the ftomach, attended with purging. At firfr. he voided flime
but afterwards white fibrous fubilances, in fome meafure refembling
afcarides, together with thin membranes ; he complained of want
of appetite, low fpirits, dimnefs of fight, and giddinefs, which laft was
fo confiderable, that he was fometimes in danger of falling down :
his pulfe was weak and quick, and his ftrength much impaired,
though he continued to walk, about till the day of his death, which
happened four months after the commencement of his illnefs. He
had then two fainting fits, in the laft of which he was carried to bed,
and died quietly a few hours afterwards.
B On
( 2 )
On opening the cavity of the abdomen, the ftomach was found
adhering above to the liver, and below to the pancreas. It was
diftended with putrid air, which burft forth on feparating the
adhefion at the liver. Great part of its upper fide was confumed,
and that portion of the liver in contact with the difeafed part of the
ftomach, was ulcerated and covered with a putrid reddiih matter.
The lower part of the flomach adhering to the pancreas, had fuffered
in like manner. The parts by which it adhered, and fome others,
were thickened, foft, fpongy, and in general rotten. It contained
a large firm clot of blood, weighing almofl a pound, together with
fome putrid matter. The pylorus was greatly thickened, but the
paffage was free. The duodenum and jejunum were of a dark bluiih
colour, but the extremities of the villi of the latter were quite black.
The ileum, and large interlines, were, to all appearance, found.
Was it not furprizing that, in the preceding cafe, the patient
never complained of ficknefs, nor was troubled with retchings ?
Perhaps the flomach was too weak for that exertion.
§ 2. Inflammation of the J mailer Inteftines, with Effufwn of Blood*
A man aged thirty, unknowing of any caufe, was, one evenings
fuddenly feized with retching and vomiting, which were frequent
day and night ever after, and conftantly and immediately followed
the fwallowing any thing, even in the fmalleft quantity. His fkin
became yellow on the fourth day, and what he vomited was obferved
on the eighth, to be of a coffee-colour. His ftools were fmall, and
of a natural appearance, and he had one every day till the tenth. A
glyfter being then adminiflered, a purging with blood enfued. Some
of the ftools confided of clots of blood, with hardly any mixture of
other
( 3 )
other fubftances : the fkin and eyes were yellow ; his breathing was
opprefled ; the expirations terminated in a flight groan, and were
about twen ty- five in a minute : his tongue, on both furfaces, was
covered with a whitifh flough ; his pulfe was quick and full ? he
had conftant ficknefs, and vaft uneafinefs acrofs the flomach and hy-
pochondria; the fever encreafed, the tongue and lips became hard
and black, and, retaining his fenfes to the laft, he died on the thir-
teenth day.
On examining the body, the flomach and large inteftines were,
externally, of an afh-colour ; the fmall inteftines, in general, were
of a blackifh red ; towards the lower extremity, of a deep red ; and
towards the upper extremity, of an olive, or greenish brown colour.
A portion of the duodenum, a little below the ductus choledochus ;
alfo a portion of the fundus cceci, were of a very dark red
colour, blood being effufed between the peritoneal and mufcular coats.
Internally, The ftomach, duodenum, and jejunum, were of a dirty
brown, or blackifh colour; the ileum was uniformly of a deep
red, and, after being wiped, gave, when preiTed, a reddifh taint to
a white cloth : the rugs, and fome other parts of the furface of the
colon and rectum, were of a light red colour; the parts mofl
affected did not, when pulled, appear to be at all weak or tender :
the bile was almoft black ; the contents of the ftomach, and duo-
denum, were a corTee-coloured fluid : thofe of the jejunum were a
foft fubftance, like meconium : thofe of the ileum were a dark red
fubftance : thofe of the colon were pure red ; the colour of the
liver, on its lower furface, was dark blue ; internally, it was found ;
the gall ducts were quite open : the other parts of the abdomen,
and thofe of the cheft, were in a found ftate.
B a § 3. Bfocknefs
( 4 )
§ 3- Bkcknefs of the cellular SubJIance, and Erofions of the internal
and neighbouring Coats of the larger Intejlines.
A man, aged fifty, was, when in the Eafr.- Indies, feized with a
violent bloody flux, accompanied with excefilve pains in the bowels,
and almoft conftant {training. The flux, though lefs fevere, con-
tinued almoft conftantly tor four years afterwards, and he commonly
voided very tough flime. After that period, it gradually diminished,
and had entirely flopped about a month before his death ; which,
as will afterwards appear, ( § 9. ) was probably owing to a large
abfcefs in the liver.
A woman, aged thirty, after being wet, was feized with pains,
in her limbs and bowels, and, in a week afterwards, with fo violent
a purging, that there was fometimes not a minute, feldom more than
ten minutes, and never, me faid, above half an hour, between her
ftools : fhe did not void above a fpoonful at a time ; it was of -a
natural colour, but frothy and vifcid : the pulfe was very irregular ;
and the tongue covered with an olive- coloured fur. After a very
confiderable remiflion, the Ji/Ordti returned with the utmofl violence,
and carried her off" in about two months from its firfl attack.
In both cafes, the cellular fubftance, between the internal and mufcular
coats of the large interlines, was black, but gave no tinge to water. The
blacknefs was either in fmall circles, or in fpots, or diffufed over
large portions of the cellular fubftance : in the middle of fuch fpot3
as were larger and deeper-coloured than the reft, the internal coat
was
( s )
was broken by a very fmall erofion. We oblerved other erofions^a
little larger, penetrating into that membrane ; they appeared fome-
times white, but moft commonly black ; others, ftill larger, and
which were always white, ran into the mufeular coat : in the parts moil
difeafed, more than half the internal coat, great part of the cellular,
the tranfverfe and fome of the longitudinal fibres of the mufeular
coat, were confumed ;-f externally on the peritoneal coat, faint
brownifh fpots were feen oppofite to the deep black internal fpots ^
the fmall inteilines were not to appearance difeafed.
§ 4., The glandular Follicles of the great Intejlmes much enlarged >
and Jilled with a glutinous Subjlance,
A woman, aged twenty-feven, was, after an irregular intermittent,
feized with fevere purging, accompanied with excruciating pains of
the bowels. What the voided, was a thin olive- coloured fluid, with
many fmall portions of a clear glutinous fubftance floating in it ; they
fomewhat refembled drops of oil : her pulfe beat commonly about 90
in a minute, and was fmall ; her tongue was uncommonly dry.
No confiderable remiflion having happened, me died in about fix
weeks after the purging began.
A man, aged fifty-fix, fome months after a tedious fever, in which,
his ftrength had been greatly impaired, was feized with a purging,
which, though fometimes violent, frequently remitted, but never
wholly
* In the inteftines of the man were obferved the circles, fpots, and fmaller erofions :
in thofe of the woman, befides thsfe appearances, were obferved the more advanced,
changes.
( 6 )
wholly flopped. Pain of the bowels commonly preceded each fit of
purging : what he voided, in the beginning, had been often mixed
with blood, but afterwards it was mixed with fmall manes of a clear
glutinous fubftance, coagulable by heat, or by alcohol, and fome-
times it wholly confifhed of that fubftance. Part of the food, efpe-
cially liquids, palled through the body unaltered : his pulfe beat
about 90 •, his tongue was dry. The diforder was conftant and
violent for above a month before his death, which happened in
eleven months after the purging began.
In the large interlines of both, portions of the internal coat were railed
up into fmall hemifpheres, containing a colourlefs glutinous fubftance,
which was rendered white and firm by alcohol, or by heat, but by
cold water was foftened, and partly diflblved.* On the internal
furface there alio appeared irregular eminencies and depreffions, both,
of which were covered by the internal coat : the former were white,
both externally and internally ; the latter externally were commonly
livid, and fometimes they were in fpots : under the eminencies the
cellular fubftance was thicker and more folid -y under the depreffions
it was thinner than in the found portions of the inteftines.-f- In the
loweft part of the ileum, we obferved eminencies of the fame colour
and ftrudture as thofe in the colon. |J There were alfo a few irre-
gular erofions of the internal coat in the firft cafe. J In the fecond,
we obferved erofions fimilar to thofe defcribed under the next
article. The other parts of the fmall inteftines were in a found
ftate.
Were
'* Fig. 2, 3. b by c, &c. d, iv. & v. a, &c. b.
•v Fig. 3. a a. I Fig. 5. A B. J Fig. 3, (.
( 7 >
Were the hemifpheres, above defcribed, the inteftinal glands, en-
larged ? Was the coagulable part of the blood fecreted by them,
inftead of common mucus ? Is the voiding of a clear gelatinous fub-
ftance, in fmall feparate maffes, the fign of this ftate of the in-
teftines ?
§ 5. Strifture in the Reffum, and TLrofion of the Glands of the
Ileum*
A man, aged forty-fix, had almoft recovered of a flux, which had
continued about a year, accompanied with gripings, and after each
motion, with blood dropping from him, when, twelve days before
he died, the paflage of his body was entirely mut up; the belly
fwelled, and for fome time was partially pufhed out by portions of
the colon. Glyfters and whatever he drank were immediately re-
turned, the former with wind. There was much noife in the
bowels. The belly becoming at laft uniformly fwelled, he died in
the utmoft agony.
The colon was every where diftended, to almoft five inches in
diameter, by thin feces and air, which laft, through fome fmall aper-
tures in the coats of the intefHne, had burft into the cavity of the
abdomen. The ftomach was compreiTed by a flexure of the colon,,
which almoft entirely filled the left hypochondrium, and the di-
ftenfion of this intefline terminated at a ftricture thereof, a little
above the reflexion of the peritoneum over the bladder. At this
ftri<fturethe pafTage was almoft wholly fhut up, by a kind of tubercles,
fbft, fpongy, and rotten. We obferved fome erofions of the internal
coat of the coeeum?J and in the lower part of the ileum y alfo erofions
of
( « )
of what is commonly called Peyer's glands ; * and, near the attach-
ment of the mefentery, we difcovered fmall holes of the internal
coat,-f- fome of which might, by prefiing upon the veffels near them,
be filled with blood. The other parts of the alimentary canal were
internally found.
§ 6. Irruption into the Colon of Matter collected mar the right
Hypochondrium.
In a man aged thirty-four, during a bloody flux, accompanied
with pain chiefly in the upper part of the belly, a hardnefs was
felt, and foon afterwards a tumor appeared near the right hypochon-
drium. In about three months the flux flopt; but the tumor in-
creafed for two months longer, when it broke ; and, the opening
being enlarged with a knife, difcharged about a pint of a thick
reddifh matter. At this time the purging returned, and in three
weeks he voided matter refembling that difcharged at the wound,
where, while forcing at flool, there was often a bubbling noife.
Lying on the left fide was foon followed by a motion to flool, and preflure
on that fide of the belly forced the matter through the anus. The
purging increafing, and the difcharge, though fmall in quantity,
continuing from the tumor (which had now almofl quite fubfided),
he died in about feven months from the firft attack of the purging,
and two months after the breaking of the tumor.
The parietes of the abdomen, the edge of the right lobe of the
liver, and the neighbouring part of the tranfverfe arch of the
colon, were found adhering to one another, and all of them in fome
degree ulcerated. The colon was at that part perforated by fome
very
* Fig- 7- t F'S- 8-
( 9 )
very fmall apertures ; and its internal coat, in many places, chiefly
near the apertures, irregularly eroded.
§ 7. Numerous ConJlrlBions of the Intejllnes.
A man, aged nineteen, by trade a brazier, having for nine
months been often afflicted with pains, fenfe of twilling of the
bowels, and coftivenefs, was feized a fortnight before his death
with a violent fever, attended in the beginning with purging, and
towards the end with ftupor.
Another man, aged fixty-five, by trade a houfe-painter, was, for
the laft five years -of his life, frequently afflicted with violent pains in
his bowels, accompanied with coftivenefs : he was oft times nine
or ten days without a ftool. About a month before his death, being
greatly weakened and wailed with his difordcr, he was feized with a
purging, which, though moderate, carried him off.
In both fubjecls, the fmall, as well as the large inteftines, were
found alternately contracted anH AAxte-A . the contracted parts in the
former v/ere about one quarter of an inch ; in the latter about half
an inch in diameter ; they were both externally and internally of a
deep red colour, feemingly from the enlarg§ment of the blood
vefTels. The widefl portions were nearly four times larger than
the narrowed.
§ 8. Hardmfs
10
§ 8. Hardnefs of the Liver, and thinncfs of the Bile,
A man aged thirty, after a fever, became yellow, and continued fo
almofl conitantly for four years, his colour being fenfibly deeper every
time he caught cold ; but except a flight loofenefs, to which he was
now and then fubject, he had no other remarkable complaint till
three weeks before his death. He was then feizedwith thirit, fever,
great pain in the upper part of his belly, and in both hypochondria j
a frequent cough, his breathing fhort and painful, his fkin and eyes
of a deep yellow, his tongue clammy, the greater part of it very red,
and one edge of it covered with a white ilough j his belly was tenfe
and fwollen..
On difleclion the liver appeared large, and of a dirty brown colour :
xt was hard and uneven on its farface, which was raifed up into fmali
eminencies in clufters. Externally, it was variegated, dark orange
and dark green being mutually interpofed. On preling the gall
bladder, a thin tranfparent bile, of a deep green colour, was
forced into the duodenum -, no ftone, conftriction, or other difeafed
appearance, was found in the gall-ckiars or gall-bladder, though both
were accurately examined. The omentum was thick and opaque,
and turned upwards over the flomach and liver : over the ftomach,
it was attached to the diaphragm at its edge ; over the liver, by a
broad furface ; but it did not adhere to either of thofe organs : the
fmall intcflines adhered by their convolutions to one another, and to
the parietes, being covered with a kind of cellular fubftance. In-
ternally,, they were in a found ftate..
§ 9. Abfcefs
( » )
§ 9- dbfcefs of the Liver.
A man, who (as already related, § 3,) had been much afflicled
with a flux, was, about iix weeks before his death, feized with fits of
coldnefs, which came at firft at irregular periods, but afterwards eveiy
forenoon. In the beginning, they lafled four or five hours only, and
were followed by heat, head-ach, and thirft ; but towards the end
they lafled all day, and were followed by burning heat, continuing
throughout the night. The ftools were of an afh-colour.
In the right lobe of the liver was an abfcefs, containing about half
a pint of matter -, the gall-bladder was large, and full of pale yellow
bile.
§ 10. Hydatides in the Liver,
A man, aged twenty-nine, was, three months before his death,
feized with pains in the right hypochondrium, foon followed by a fwel-
ling of the part, and yellownefs of the fkin, and afterwards by a fwel-
ling of the whole belly. A fortnight before he died, he was taken
with a purging and vomiting, of dark-coloured matter, accompanied
with exceffive gripings. The vomiting ceafed in a few days, the
yellownefs of the ikin difappeared, the belly fubfided, the pains abated,
and the purging only remaining, he, two days before his death,
thought himftlf greatly better.
On dhTe&ion, the abdomen contained feveral pints of a muddy
liquor, tinged yellow ; the right lobe of the liver was greatly
C 2 lengthened,
( «3 )
lengthened, its lower furface being puflied out, formed, with the
upper one, a continued convexity ; and matter ifiued from fome fmall
apertures on its furface. Internally, there were two large cavities,
containing about three quarts of a lightifh brown thick fluid, and
many round gelatinous tranfparent bags, white or yellow j the gall-
bladder, at the bottom of which was a large opening, was included
in the anterior of the two cavities ; the gall- ducts were widened, and
opened freely into this cavity and into the duodenum. The left lobe
of the liver was nearly found. A part of the jejunum was reflected
over the omentum and colon, adhering to the liver and to the
parietes*
§ ii. TVhitiJlj Granules, or Tubercles in the Liver.
On examining the bodies of two perfons, neither of whom had
any fymptom of an affection of the liver, both having laboured under
complaints of the chelt, and which, on diffection, appeared the chief
feat of difeafe ; the liver, though not considerably enlarged, through-
out its whole extent contained fmall whitifh granules, which were
not vafcular but fmooth, almoft tranfparent, and fo numerous, that
they occupied more than half the fpace naturally filled by this vifcus.
The gall bladder was very fmall, and contained little more than a
tea-fpoonful of bile.
§ 12. The common Gall-ducJ Jhftt up by a Gall-fane, and the
Hcpatic-duc~l opening into the Duodenum.
In the body of a man who died of a fever, without having any
fymptom of jaundice, the extremity of the ductus choledochus was
quite
( '3 )
quite (hut up by a large gall-ftone, which protruded into the duo-
denum ; the gall-bladder was greatly contracted, empty of gall, and
covered all over with a cellular fubflancej the ductus hepaticus ad-
hered to the duodenum, and opened into it about an inch below the
pylorus : over the gall-bladder, the edge of the liver was a little
rounded. This vifcus was in other refpects found.
CHAP. II.
A Defcription of the Symptoms of Difeafes of the Stomachy &c. taken
from thoje Cafes where the Patients recovered, or where the Author
had no Opportunity of examining the Bodies after Deatb.
§ i . Vomiting.
BLOOD is fometimes thrown up by vomiting, mixed with the food,
or with the liquors of the flomach. The ufual fymptoms accom-
panying this, are, giddinefs, pain of the head, and, in fome instances,
pain in the left hypochondrium, increafed, after eating ; with exquiflte
forenefs, when folid food, hot liquors, or hot medicines, are pafBng
down into the ftomach , and, in other cafes, weight at the fcrobi-
culus cordis, ficknefs after eating, till the food is brought up , dim-
nefs of light, difagreeable dreams, and purging of black matter, or
of blood. This diforder fometimes follows a blow or a fprain : moil
commonly the caufe is unknown. In the firft inilance it terminated
favourably,
§ 2. Purging,
( H )
§ 2. Purging.
Thofe cafes of purging which I had an opportunity of obfervlng
at the hofpital, were accompanied with thirft, want of appetite, foul-
nefs of the tongue, quicknefs of the pulfe, gripings, noife in the
bowels, {training, with pain in the fundament; and fometimes the food
pafied unaltered. They may, according to the matter voided, be
divided into two fpecies ; the flimy, and the gelatinous : in both of
which blood is frequently paffed. In the flimy purging, the {tools
are frothy, and confift of a yellowifh or whitim, vifcid, ropy matter -,
which, unmixed, is fometimes, with the utmoft {training, forced off
{balding hot, -and fometimes panes off almoft involuntarily. This
{pedes is often accompanied with darknefs before the eyes, giddinefs,
retching, vomiting. In the gelatinous purging, the {tools are either
a thin liquid, containing fmall, clear, whitifh gelatinous fub-
{tances, or almoft wholly jelly ; and fometimes nothing but wind is
voided. In this fpecies, any liquid taken into the body is apt imme-
diately to run off with fevere gripings. The duration of either fpe-
cies is, moft commonly, a few weeks ; fometimes two or three
months : and, in one cafe, the flimy purging continued three years.
The event is frequently fatal. The caufes are uncertain.
Is it not probable that, in the firft fpecies, the bowels are in
the ftate defcribed (§. 3.) 5 that, in the fecond, they are in the
ftate defcribed (§. 4.); and that, when bloed is voided, which
happens in either fpecies, it proceeds from the erofion of blood-
yeffels, as delcribed (§. 5.) ?
5 3' Cojiivmefs*
( »s )
§ 3. Cojiivenefs..
The almoft conftant attendants on coftivenefs, are head-ach, fick-
nefs, vomiting. It is accompanied alfo with flight pricking, or
ievere and violent pains ; either in the right fide of the belly, near
the fcrobiculus cordis • in the left fide of the belly, near the anus ;
or over the whole belly : thefe pains are oft times increafed by flight
preffure of the part. "When the diforder is moft violent, it fome-
times has exacerbations, in which the bowels, after a fenfe of cold-
nefs in them, are, according to the feelings of the patient, twifted,
drawn together, and fqueezed to the back ; the teeth gnafh, the body
is drawn forward ; whatever is then taken is immediately vomited,
and glyfters adminiflered are returned without faeces. As the ftools
are, for the moil part, retained till the remedies given have proved
effectual, the coftivenefs, in fome violent cafes, has continued a fort-
night or a month ; and one patient, a painter, had no ftool for three
months. In general, purging medicines, and glyfters, when re-
tained, produce very foon the defired effedt. The duration of the-
difeaie is various and uncertain, but the mofl obftinate cafes continue
fbmetimes two or three years 5 intervals, which now and then happen
after a fpontaneous purging, being interpofed. The caufe, even when
the diforder is moft violent, is, at times, altogether unknown.
Lead, in various forms, and the fumes of quickfilver, frequently
occafion it in painters, and other workmen, who, in their feveral
trades, make ufe of thofe metals. It fometimes follows a blow on the.
belly, or a fprain in lifting a great weight ; and, in this cafe, blood,
or matter, is voided with hardened faeces. It did not, in any of the
inftances from whence this hiftory is drawn, prove fatal.
Arc
( »6 )
Are the bowels, in fuch cafes, fometimes inflamed ? Were they,
in the more violent cafes, nearly in the flate defcribed (§. 7.) ?
§ 4. yaundice.
This difeafe begins with ficknefs and pain at the fcrobiculus cordis,
and fometimes with giddinefs, retching, and vomiting of a yellow four
ropy phlegm. The urine is of a faffron colour, flaming paper that
is dipt in it, and becomes turbid when cold. The tunica fclerotica
of the eye and fkin are yellow; the yellownefs is firfl perceptible at
the pit of the ilomach ; external objects appear as ufual. This difeafe
is frequently accompanied with purging, though fometimes with
collivenefs : the flools are commonly in colour like blue clay ; fome-
times of a dark earthy, or of a deep yellow colour ; but, fo far as I
have feen, never white. In general, there is a bad tafte in the mouth,
with a white tongue and a flight fever; frequently, immediately pre-
ceding the vomiting, there is a violent pain in the back ; the pains
in the belly are increafed by walking; they complain of pain in
the right, or left hypochondrium, or in the flank ; and fome-
times, though rarely, of pains fhooting from the fhoulder to the
breafl, or from the back down the thighs. In fome cafes, the difeafe
intermits for feveral weeks or months, but more commonly is con-
tinued, though the pains and vomiting attack by fits, lafling either a
few hours every morning, or for feveral days. Relief always follows
fpontaneous vomiting, or purging. When the difeafe is going off,
there is fometimes a violent itching of the fkin.
Does not the relief which follows fpontaneous vomiting and
purging, point out the proper method of curing this diforder, by
emetics and purgatives ?
CHAP. III.
( *7 )
CHAP. III.
Obfervations on the EffeSi of Remedies, given in the Cure of Difeafes
of the Stomach, &c.
OPIUM alone feldom failed to reflrain purgings for two or three
days or a week ; but the difeafe, at the end of thofe periods,
returned, and commonly with more violence, than before opium had
been taken. But, though this drug alone appeared to be a medicine
altogether inadequate to the cure of purging, yet when combined
with others, moll excellent medicines were formed, whofe effects
were not lefs powerful, and were more lalting.
In the ilimy purging, the moil: efficacious medicine was vitri anti-
monii cerati* gr. v. opii circiter gr. i. quotidie. Another powerful
medicine was radicis columbae gr. x. opii gr. i. in die. Columba root
alone gave only a temporary relief. In the gelatinous purging the mofl
efficacious medicine was ipec. gr. i. opii gr. i. quotidie. Vitr. an-
tim. cerat. cum opio, given in this fpecies, aggravated the iymp-
toms. Other ufeful medicines, in either fpecies, but of inferior
efficacy, were opium with rhubarb, with aromatics, with abforbents,
or the abforbents alone. When the pains were violent, fomentations
gave much relief. In coftivenefs, the bell; remedies were fomentations
and the common purgatives. In the painter's colick, oil, or oil
with rhubarb, was moll ufeful. In the jaundice, emetics and pur-
gatives were ufeful remedies.
r> is
* A medicine in the Edinburgh Pharmacopoeia.
( "3 )
Is not the combination of opium with other drugs, recommended
to us by practitioners in all ages, and of all fedls ? Have we not an
example of this in the antient compofitions Mithridate, Theriaca,
and feveral others, which are flill retained in the modern difpenfa-
tories, and in which opium is a principal ingredient ; alfo, in the
highly celebrated medicines of Dover, and of Ward, the moil effi-
cacious of which are opium joined with ipecacuan, with hellebore,
or with mercury.
PART II.
( 19 )
PART II.
Difeajes of the Chefl.
CHAP. I.
Difeafes of the Chef, illujkrated by Diffeclion.
§ i. 'The Canal of the Aorta almofk jlmt up by the fcmilunar
Valves.
A WOMAN, aged twenty-one, who got her bread by hard
labour, had, for five years, been fubject to fits of palpitation,
which attacked her commonly after an interval of fome months : the
laic fit, in which fhe died, lafted five weeks, being more violent and
of longer continuance than any of the preceding ones. In this fit,
the left hypochondrium and fcrobiculus cordis were much pufhed out
at each palpitation ; there was alfo a remarkable throbbing in the
courfe of the veflels on each fide of the neck, but from the
irregularity of thofe motions, they could not be counted, and
the parts themfelves were fo tender, that fhe would hardly allow
them to be touched. Her pulfe was weak, quick, and irregular,
fometimes fluttering, fometimes intermitting : fhe complained of
pain and tightnefs acrofs the cheft ; her breathing was oppreiTed and
quick, infpiring commonly forty-five times in a minute ; fhe had a
fhort cough, was low, faint, confbntly fick, and, for rnoft part,
vomited immediately after fwallowing the fmalleft quantity of any
thing, whether liquid or foli'd. At firft, fhe lay on her left fide,
or on her back ; afterwards on her back only, having her head and
D 2 moulders
( 2° )
mouldeis raifed up, and at laft with her arms folded over her head.
She became anafarcous a month, and yellow two or three days before
her death.
On diffection, the lungs were found adhering to the pericardium,
and to part of the parietes of the cheft near it : in other places de-
tached, every where foft, and, when prefTed, froth iffued out of the
noftrils. The femilunar valves of the heart were thickened, and
projected towards the axis of the aorta.* The heart was feemingly
lengthened, in other refpects found. The large blood- veffels, which
were traced and cut up, as far as the head and arm-pits, were alio
found. The abdominal vifcera were in a natural ftate.
§ 2. Pericardium adhering to the Heart, &c.
A woman, aged twenty-feven, was, fbme months before death,
feized with a frequent dry cough, followed by pain in the left hypo-
chondrium, and at the fcrobiculus cordis : her breathing was fhort
and quick, her pulfe commonly one hundred in a minute ; fhe com-
plained of ficknefs, with conftant and often violent head-ach. A
fortnight before her death, me loft the ufe, firft, of the left arm •„
then of all the left fide, and her fpeech faultered..
The pericardium was found adhering every where to the heart,
which, was much enlarged, and hardened, but internally found ; the
lower, and greater part of the lungs of the left fide, were of a dark
red colour, firm, and adhered to the neighbouring parts ; there was
a. very ftnall quantity of water in the right cavity of the cheft. The:
ftomack
( « )
ftomach was narrow : the other abdominal vifcera had a natural
appearance.
§ 3. The Pericardium enlarged, containing eight Ounces of a Fluid,
and, by fatty Papilla?, adhering partially to the Heart.
A girl, aged fourteen, was, three weeks before her death, feized:
with great difficulty of breathing, and with pain in the left fider
attended fometimes with a fhort cough, which was not at all relieved
by repeated ven affection. When in bed (he lay conftantly on the left
fide, her cough being excited by any attempt to lye on the right fide,
or on her back. She often chofe to fit up; but whether fitting or
lying, the b©dy was always much bent forward. The pulfe was
full, and very quick.
The pericardium was much enlarged, and being covered towards
the upper part with a foft fubftance half an inch thick, concealed all
the lungs of the left fide, except a fmall portion of the upper lobe
near its edge. It contained eight ounces of a fluid : its internal fur-
face, and alfo the external furface of the heart, was covered, in many
places, with a layer of a kind of fatty matter, eafily feparable from
either furface, and fupporting numerous oblong fatty papilla?. The
oppolite papillae on the pericardium, and on the heart, in fome places,
adhered to one another. The great veiTels within the pericardium,
were covered by a, foft fubftance a quarter of an inch thick. The
heart and great veiTels, internally, were found. The lungs adhered,
univerfally, though flightly ; were in every part foft, and eafily dilated.
by air blown in by the windpipe. There were fbme ounces of a rluid in
eacJx,
( ** )
each cavity of the cheft. The abdominal vifcera, except the right
kidney, were quite found.
On examining the body of another woman who died of a con-
fumption, but who, a fortnight before her death, had lain alfo, night
and day, bent forward on her elbows and knees, the pericardium
contained much water.
§ 4. Ulceration of the Lungs, or pulmonary Confumption.
The frequency and fatality of this diforder having afforded me many
opportunities of obferving the fymptoms, and of examining the ftate
of the body after death, I fhall here, inftead of particular inftances,
endeavour to give a general defcription of the fymptoms, and of the
appearances on diffection, taken from ten cafes, where the difeafe
proved fatal.
Symptoms of the Difeafe.
The fymptoms of the difeafe may be divided into primary and
fecondary •> the former being fuch as are peculiar to affections of the
cheft, the latter, fuch as are common to thofe, and to fome other
affection s.
Of the firft kind are cough, fpitting, pains of the cheft, difficult
breathing, and pofture. Of the fecond kind may be reckoned cold-
nefs, heat, fweating, purging, wafting, pains of the limbs, &c.
The cough, which is brought on by expofure to cold, or by
drinking any cold liquor whilft hot, or by various other caufes, is
almoft
( 23 )
almoft conftantly the nrft fymptom, and in the beginning often the
only one -y though it is, at times, accompanied with flitches, or
mooting pains in the cheft, and with expectoration. It generally
attacks by fits, which are moil frequent and fevere towards evening,
or during the night, preventing fleep.
The (pitting or expectoration, is commonly very thick and vifcid,
of an afh- colour, with a flight tinge of green, and contains many
air bubbles ; fometimes it is yellowifh, and in fmall round maffes,
which probably come from fmall vomica? ; now-and-then, though
rarely, it is ftreaked with blood. The quantity expectorated is
generally inconsiderable in the beginning, but afterwards increafes to
about half a pint, or a pint, in twenty-four hours. In thofe cafes,
where (upon diffection) the large vomica? were found almoft empty,
the fpitting, towards the end, had been in very fmall quantity.
As the fpitting is, perhaps, the moil certain criterion of vomica,
it will be proper to enquire into its peculiar character, that it may be
diftinguifhed from pus and mucus : two fubftances which it greatly
refembles. All of them, when free from air bubbles, fink in water.
Pus is eafily difFufible in it, by gentle agitation, but in a few hours
falls to the bottom. Mucus cannot be equally difFufed in water
without ftrong agitation, but when difFufed, forms with it a per-
manent ropy liquor. The fpitting of confumptive perfons is diffufible
in water more eafily than mucus, and like that, at firft forms with
it a permanent ropy liquor ; but which, in a few days, depofits a
fediment in the fame manner as pus ; the liquor, however, ftill con-
tinuing ropy, and refembling mucus and water.
The pains of the cheft are of two forts ; viz. ftitches, which
fometimes come on in the beginning ; or a general forenefs
of
( 24 )
of the cheft, which is moll feverely felt after violent fits of
coughing.
The breathing (even before the difeafe has arrived at its acme) is.
generally two or three times more frequent than that of a perfon In
health, and is often accompanied with a fighing noife, and performed
with great motion of the chefl ; but it is fomewhat relieved by the
expectoration which follows the fits of coughing. Neither in-
fpiration, nor expiration, can be continued fo long as by a healthy
perfon ; but the former, in confequence of the pain or cough excited
by it, is moft. fenfibly fhortened.
With refpect to pofture, the patient commonly lies on his right fide ;
but this is not compleatly fixed till the difeafe is far advanced, when
he can only lie on his back, with his head and fhoulders high, and
fometimes with his knees drawn up.
The coldnefs (which fometimes precedes any figns of an affection
of the chefl) comes on by fits, either regularly every day, or every
other day, like the paroxyfms of an intermittent fever ; or, as is
mofl common, at uncertain periods.
The heat is of two kinds, either a burning heat, with intenfe
thirft, continuing all night, which fucceeds the fits of coldnefs ; or
a continued heat, increafing towards evening, which, in general, is
much more moderate.
The pulfe is always fmall and quick ; commonly there is a lofs of
appetite, though, in fome inftances, towards the end of the diforder,
the appetite is voracious.
The
( 25 )
The Sweating is alniofl a conftant fymptom, and is at times profuie,
breaking forth, chiefly, on the head and breaft ; though more com-
monly it is moderate, and follows the evening exacerbation ; and
fometimes towards the end, it diminiilies, or ceafes.
i
The purging feldom comes on till near the end of the difeafe, at
which time the legs are apt to fwell. When the purging begins all
the feverifh fymptoms greatly abate, but are again increafed, if, by
any means, it is flopped.
The wafting of the body is more remarkable in this, than in any
other difeafe.
Pains in the limbs, or all over the body, are alfo not unfrequent
fymptoms ; and the menfes, in women, (who are more liable to this
difeafe than men) commonly ceafe jfoon after it is eflabliihed.
The duration of the difeafe is various, from four months to two
years ; and it will be found to be nearly in proportion to the age of
the patients, which varies from feventeen to thirty-five years.
Appearances on Dtjfeftion.
As the appearances on direction, though extremely uniform, are
very different in degree, it may be ufeful to arrange them under the
following heads: — Tubercle; Vomica; State of the Air Veficles,
and cellular Subftance ; State of the large Blood VeiTels j Trachea ;
the Degrees of morbid Affection j and fome other circumftances.—
E Tubercle.
( «6 )
tubercle.
In the cellular fubftance of the lungs are found roundifh firm
bodies, (named tubercles) of different fizes, from the fmalleft gra-
nule, to about half an inch in diameter; the latter often in clutters..
The tubercles of a fmall fize are always folid, even thofe of a larger
are frequently fo ; they are of a whitifh colour, and of a confidence
approaching nearly to the hardnefs of cartilage ; when cut through,
the furface appears fmooth, mining, and uniform. No veficles,
cells, or veffels are to be feen in them, even when examined with a
microfcope, after injecting the pulmonary artery and vein. On the
cut furface of fome tubercles were obferved fmall holes, as if made by
the pricking of a pin ; in others were found one or more fmall cavities,
containing a thick white fluid, like pus ; at the bottom alfo of each
of thefe cavities, when emptied, feveral fmall holes were frequently
to be feen, from which, on prefting the tubercle, matter iffued ; but
neither thefe holes, nor the others abovementioned, (fb far at leaft as
could be determined) communicated with any veffels. The cavities,
in different tubercles, are of different iizes, from the fmalleft per-
ceptible, to half an inch, or three quarters of an inch, in diameter;
and, when cut through and emptied, have the appearance of fmall
white cups, nothing remaining of the fubftance of the tubercle, except
a thin covering or capfula. The cavities of lefs than half an inch
diameter are always quite (hut up ; thofe which are a little larger
have, as conftantly, a round opening made by a branch of the trachea.
At this period, there being a free paftage for the matter contained in
the tubercle into the trachea, and.a, communication between the cavity-
of it and the open air, it is proper to change the name of tubercle to
that of vomica.
Vomicae
( *7 )
Vomica.
The fmaller vomicae are commonly entire, the larger are frequently
ruptured j the largefl: (which, generally fpeaking, are of an oval
fhape,- and about four inches in length) i r^ lined, either partially, or
entirely, with a fmooth, thin, tender Hough or membrane ; the fame
as the capfula of the fmaller vomicae. The matter contained in them,
when the capfula is entire, is whitifh or yellowiih ; when ruptured,
reddifh ; in either cafe readily diffufible in water. It is proper, how-
ever, to remark, that even in the largefl vomicae, when they are not
compleatly ruptured, the matter is feldom red, but yellowiih, afh-
coloured, or greeniih jj often foetid.
Into all vomica; (the fmallefl perhaps excepted) there are feveral
openings of the bronchia ; alfo openings forming communications
between the different vomicae ; the bronchial openings are commonly
round and fmooth ; the others, generally irregular and ragged. The
larger vomicae, which have numerous bronchial openings, are found
to contain fcarcely more matter than is fufficient to befmear their
furface ; and what fhews clearly that the matter of vomicae is dif-
charged by thefe openings of the afpera arteria, is, that if a deep
incifion be made into any difeafed part, of the lungs, and that part
gently compreffed, the matter will be {qgd. to ifTue from the cut ex-
tremities of the bronchia ; or if any considerable branch of the afpera
arteria be laid open, and the lungs preffed in the fame manner, the
matter will be ftcn coming into it, from the fmaller ramifications.
The largefl vomicae are generally fltuated towards the back part of
either upper lobe, and are commonly concealed ; though fometimes
E 2 on
(28 )
on the furface of that part of the lungs, which is thin and finks into
a hollow, there are feveral fmall apertures leading to the vomica ; and
fometimes, though rarely, a vomica is a hemifpherical cavity on the
outward part of the lungs. Wherever there is a vomica there is
always a broad and firm adhefion of that part of the lungs to the
parietes, or pleura, fo as to preclude all communication between the
cavity of the vomica and that of the cheft ; even tubercles are feldom
found without adhefion.
State of the Air Veficlesy and cellular Subjlance.
Thofe parts of the lungs which are contiguous to tubercles are red,
fometimes foft, but more frequently firm or hard -, and whilft other
parts of the lungs unaffected by difeafe are readily diftended, by blowing
into the trachea, thofe portions which are contiguous to tubercles or
vomicae, remain deprefTed and impervious to air, either blown into
the lungs in this, manner, or forced, by a blow-pipe, into incifions
made on the furface. So that the function of the lungs, fo far as
refpeds the admiflion of air, feems, in thofe parts, entirely deflroyed.
State of the large Blood VeJJels*
The pulmonary arteries and veins, as they approach the larger
vomicae are fuddenly contracted ; a blood veffel, which, at its begin-
ning, meafured nearly half an inch in circumference, fometimes
(though it had fent off no confiderable branch) could not be cut up
farther than an inch ; and when, outwardly, they are of a larger
fize, yet, internally, they have a very fmall canal, being almofl filled
up by a fibrous fubflance ; and frequently, as they pafs along the fides
of vomicae, they are found quite detached, for about an inch of their
courfe,
( 29 )
courfe, from the neighbouring parts. That the blood vefTels are thus
obftructed, and that they have little or no communication with the
vomicae, is rendered ftill more evident, by blowing into them, or
injecting them ; by blowing they are not fenfibly diftended, nor does
the air pafs into the vomica?, excepting very rarely, and then only by
fome imperceptible holes j and, after injecting the lungs by the pul-
monary artery and vein, the parts, lefs affected by difeafe, which before
injection were the fofteft, become the hardeft ; and, vice verfa, the
moft difeafed parts, before injection the hardeft, are now the fofteft.
Upon cutting into the founder parts, numberlefs ramuli may be feen,
filled with the wax, but in the difeafed parts there is no fuch ap-
pearance ; and upon tracing, by diflection, the injected veffels, thofe
which terminate in the founder parts may be traced for a long way to
the fmaller ramuli, but thofe which lead to tubercles and vomicae, a
very fhort way, and only to their principal branches. The wax was
very rarely found to have entered the middling fized vomicae, and
never the fmaller or larger ones.
trachea*
The branches of the trachea are never found in any degree con-
tracted ; the internal furface of thofe which opened into the large
vomicae, was of a deep red, (feemingly from the enlargement of veffels)
and the internal furface of the trachea itfelf, was fometimes partially
red.
The Degrees of morbid AffeElion.
The degrees of morbid affedion are very different, in different fub-
jects, and in different parts of the lungs of the fame fubject. In fome
cafes
( 3° )
cafes there are no vomicae to be found above an inch in diameter ; in
others, feveral of two, three or four inches. In the former cafes,
the pulmonary arteries and veins are hardly fenfibly contracted. Some-
times not above a third or fourth part of the lungs are affected ; at
other times, the lungs, of one or both fides, are entirely difeafed.
From a rude calculation made on difeafed lungs, the part which re-
mained fit for the admiflion of air, may be eftimated, at a medium,
to be about one fourth of the whole fubftance of the lungs. When
the lungs are only partially affected by difeafe, the difeafed parts are
always the higher, and rather the pofterior -, whilft the found parts are
the lower, and rather the anterior. When they are wholly difeafed,
the higher and poflerior parts, are always much more fo than the reft ;
and the lungs of the left fide are more commonly affected than thofe
of the right.
The lymphatic glands in the cheft are frequently blackifh, and
fometimes contain a fubftance like moiftened chalk. In the abdomen
there is not any thing remarkable, excepting, fometimes, flight
erofions of the villous coat of the inteftines.
Is a conflant cough, though unaccompanied with any other com-
plaint, a fymptom of tubercles in the lungs ? Is it, when attended
with fits of coldnefs, and with fpitting, a certain fign of vomica?? Is
not the fpitting compofed of matter from the vomicae, and of mucus
from the membrane of the trachea ? Does not the contracted ftate of
the pulmonary vcffcls, and the thickening of their coats, prevent, in
moft cafes, the fatal haemorrhages, which other wife would enfue ?
Is there not fame reafon to apprehend, that though a tranfitory relief
is fometimes afforded by fmall bleedings, the progrefs of the difeafe is
ihercby quickened ?
§ 5- *n
( 3' )
§ 5* -^n -dncurifm of the pulmonary Artery opening into a Vomica.
A man, aged twenty- nine, who had led a very irregular and riotous
life, was, for ten months before his death, fubject to a flight cough,
which came on immediately after his recovery from the meafles^
Notwithstanding his cough, he purfued his ufual courfe of life ; and,
three weeks before his death, was taken ill in the night, with a violent
bleeding at the mouth and nofe, which continued about a quarter of
an hour, and returned four times at different intervals. He was paler
weak, faint, low-fpirited, and apprehenfive of death, but breathed
eafily and coughed feldom. The night before his death he refted well,
and rofe in the morning without any particular complaint ; but,
having again laid down in bed, he was, when afleep, feized with a
fit of coughing, and blood began to flow (interruptedly), but without
any effort from his mouth, though, fometimes, it was brought up by
a flight cough, or blown haflily from his nofe. When the bleeding
began, he immediately got up, and fat upon the bed, although he
could not continue for a moment in the fame pofture, but was con-
stantly either bending forwards, or reclining from fide to fide. At
laft, in a profufe fweat, he Started upon his legs, and, with amazing
quicknefs, threw off his waifteoat : the cough and bleeding imme-
diately ceafed ; his pulfe, which before had been very quick, was not
now to be felt ; his thiglis trembled, his urine ran from him, and he
funk down into the arms of a perfon who was Standing bye, dying
without a ligh or a groan, in about ten minutes- from the time the
hemorrhage began : the quantity of blood which he loft, was about
a quart*
Ifo
( 3* )
In a branch of the left pulmonary artery, which pafTed along a
vomica, in the upper and pofierior part of the lungs of the left fide,
was an aneurifmal fac, about an inch long, and one third of an inch
broad : the coats of the fac refembled thofe of the artery, only thicker ;
on one fide of it was a (lit, with coagulated blood adhering to it, both
internally and externally ; within the fee, the coagulum was fomewhat
whitifh: externally, it was divided into three branches, formed by three
ramifications of the afpera arteria, that opened into the vomica ; the
other ramifications of the afpera arteria, and even the trunk itfelf, being
alfo filled with coagulated blood. There was no blood in the veficles of
the lungs, which were, every where, evidently diftended with air, and
the air, upon prefTure, readily pafTed from one lobule to another, but
could not be forced out at any branch of the trachea, except at the
vomica above-mentioned. On opening the chert, the lungs did not
fubfide ; they were of a light grey colour, with many fmall afli-
-coloured granules, but no adhefion of their furface, no other vomica,
tubercle, or hardnefs, in any part of them. There was no blood in
any of the cavities of the heart, excepting a few fmall clots between
the carneas columns. In the large blood vefTels, which iffue imme-
diately from the heart, there were fome very fmall polypi. The fub-
clavian vein was empty ; the abdominal vifcera found.
§ 6. The Veficles of the Lungs filled with extravafed Blood.
Three middle-aged men were, all of them, feized, fome months
before they died, with pains in the chefl, which, in two of them,
were fevere from the beginning : in the third, moderate till within
three weeks of his death. They were accompanied with miveiing
and vomiting ; the fhivering recurred at intervals, commonly every
morning, and was followed by head-ach, heat, and profufe fweating ;
the
( 33 )
the patients commonly lay, and with mofl eafe, on the fide principally
affected, excepting in the night, when they were fometimes obliged
to fit up. The breathing was about twice as quick as ufual, and the
expirations ended with a flight groan. The cough was very frequent,
and in one cafe almoft confront. The fever was high in all, and in
two in (lances attended with delirium. The pulfe, from ninety to
one hundred and twenty in a minute, was full ; and, at laft, beat
with a kind of vibration. Pure blood burft forth, or was brought up
in confiderable quantity by coughing : in one patient, about three
weeks; in another, about one week ; and' in the third (who alone
had been repeatedly blooded in the beginning) only two days before
his death. Two of tho/e men, one of whom had lived rather fafr,
and was fubjeci to a cough in winter, became anafarcous fome weeks
before the fatal conclufion of their illnefs.
The air veficles, in fome parts of the lungs, were filled with blood,
or with bloody ferum : thofe parts did not collapfe on opening the
thorax -, they were firm, and of a very dark, or of a light red colour ;
they could not be comprefTed, nor was it pofiible to diflend them
with air blown in from the windpipe, or at punctures made on the
furface. In fome inftances, however, they did collapfe, and admitted
to a certain degree of compreflion or diflention. The lungs them-
felves were furrounded by a bloody fluid, the quantity of which varied
from a few ounces to feveral pints ; they were frequently attached to
the fides by membranous adhefions ; when cut into, a thick blood,
or bloody matter, iffued forth at the cut furfaces ; and flices cut off
from the difeafed parts, after having for fome time been macerated in
water, frill funk in it, in the fame manner as before maceration.
The infide of the trachea was pale red.
The parts of the lungs chiefly affected, in the preceding cafes,
were, in one cafe, the whole lungs of the left fide, befides a large
F quantity
( 34 )
quantity of fluid in the cavity : in another, the pofterior part of the
upper and middle lobes of the left fide j alfo the whole of the lower
lobe of the right : in a third, the whole of the lungs in both fides
were difeafed, although thofe in the right were moft confiderably fo j
in this cafe only, the bloody matter, as mentioned above, iffued at
the incifions made in the lungs. There were no other preternatural
appearances, excepting in one body, where the liver was hard and
granulated.
To afcertain more accurately the ftate of the air and blood- veiTels,
the following trials were repeatedly made on two portions of the lungs
taken from the fame body -} one of which was apparently found,
the other flightly difeafed. On the cut furface of each portion, air
was forced in by a blow-pipe j through the largefl branch, we could
find of the pulmonary artery, vein, and afpera arteria. Upon blow-
ing into the branch of the pulmonary artery, in the difeafed portion,;
the minuter ramuli were diftended, and a little air bubbled out at fome
vtry minute openings on the cut furface. Upon blowing into the
branch of the pulmonary vein, the air veficles were diftended, and
air bubbled forth at the largefl bronchial orifice ; and, upon blowing
into this lc*ft, the air veficles were diftended, and air efcaped,
with fome blood, at the large venal branch. The fame ex-
periments being made on the found portion of the lungs, the event
was fomewhat different 3 for, upon blowing into the arterial,
or venal branch, the ramuli peculiar to each were alone diftended,
and a little air efcaped at fome minute openings on the cut furface.
Upon blowing into the branch of the trachea, the air veficles were
diftended, and no air efcaped. The fame experiment was alfo repeated
on the found lungs of another fubject, and with the fame effect.
§ 7. Lymph
r 35 r
§ 7. Lymph in the Thorax,
Three men, two of them middle-aged, the third fixty-five, were
afflicted with a cough, attended with a frothy expectoration : two of
them had this complaint for fome months ; the third, who had lived
rather irregularly for fome years before his death. They were out of
breath upon walking only a few yards, and fpeaking was fo trouble-
fome to them, that they were unwilling to give any account of their
feelings ; their breathing was quick, and the expirations fometimes
terminated in a flight groan j they could blow but feebly, and for a
fhort time : they were, in general, defirous to fit up -y and, when
prevailed on to lie in bed, they were reftlefs ; or, if they continued
for any time in one pofture, it was lying on the back with the head
high, or on the fide in which (as afterwards appeared) the fluid was
contained. The pulfe was very quick and fmall ; two of them
had an inconliderable fwelling of the belly and ancles : and thofe
two who had the lungs hardened, v/ere hoarfe , the other
was not.
A yellowifh tranfparent fluid was found in one or in both cavities
of the chefl ; it coagulated by heat, though lefs firmly than the
ferum, having a larger proportion of water $ the quantity of this
fluid, in each cavity, was nearly a pint ; the lungs were, more or lefs,
difeafed in all, with partial adhefions of the higher parts of them to
the parietes : in one cafe, there were only fome fmall tubercles in the
higher part of the upper lobe ; in the other two cafes, the whole of
the upper lobes, and part of the lower, were very hard, could not
be diftended by air, and when cut into, emitted a bloody froth. In
one cafe, we obferved on the furface of the lungs, fmall bliflers,
F a containing
( 36 )
containing a clear fluid. In two bodies, there was a fmall quantity
of water in the abdomen ; and, in one, the liver was granulated,
the omentum in folds*
§ 8. Inflammation of the Pleura, and Ejfufion of Blood in the
intercojial Mufcles.
A woman, aged thirty, who for three months had been affTided
with fevere purging, had alfo, foon after this crmplaint began,
been taken with a cough, at firfl accompanied with fpitting of blood,
but afterwards of thick mucus and purulent matter. About a
month before her death, when greatly weakened by thefe complaints,
me was feized with violent pains, or ftitches, in the left fide, which
almoft entirely prevented her breathing : her pulfe, as before, was
quick, fmall, and weak : two bliflers having been applied, the
pains, in fix days, abated, and afterwards were only felt on coughing;
during the violence of the complaint, me lay on the fide affected,
but towards the end, her breathing being very fhort and difficult:
efpecially in the night, me fat bolltered up in bed.
In the left fide of the thorax, the lungs were of a very dark red.
colour, particularly at the upper part, where we found a vomica,
and fo/ne tubercles : there were alfo fome adhefions at this part, and
at this part only ; the pleura lining the ribs, was fmooth, but its
posterior part, particularly where contiguous to the intercoflal mufcles,
was of a dark red; the rednefs penetrated the mufcles, and, in
fome places, extended to the ferratus major; it feemed partly owing
to the enlargement of blood- vefiel's, but principally to an eiiiifion of
blood into the cellular fubftance, and which, by prefiure, could be
forced from one part to another. In the right fide, the lungs,.
excepting
.»■.
( 37 )
excepting a few tubercles in their upper part, were found, and free
from adhefion, nor was there any rednefs of the pleura. In each
cavity there was about a pint of yellow ferum, though the quantity
was greater in the right than in the left. The interlines adhered ex-
ternally to one another, and there was a flight rednefs to be feen on
fome parts of their internal furface.
§ 9. Suppuration of the contiguous Surfaces of the Diaphragm
and Liver.
A bkckfmith, aged fifty, having, in the depth of winter, lain
feveral nights in a cold houfe upon ftraw, was, two months before
his death, feized with pains acrofs the lower part of the chefl, dif-
ficulty in breathing, and cough, but without fpitting. The pains
fixed in the right hypochondrium, and were, fometimes, felt at the
fcrobiculus cordis. In fpeaking, he could only whifper, but was not
hoarfe. The cough was performed v/ith very little noife, and re-
fembled more a lengthened-out expiration than common coughing.
He could fuck in air, or blow it through a quill a long time, and
without pain : his pulfe was low j he lay on either fide, or on his
back, and often with the body bent forward, his chin refting upon
his breaft. Sometimes he was obliged to fit up, efpecially a few days
before his death, when he could not utter above two or three words
without flopping, and faid, he could hardly breathe, but had then
no pain.
In the right hypochondrium, the greater part of the contiguous fur-
faces of the diaphragm and liver, were inflamed and covered with pu-
rulent matter ; but the inflammation did not penetrate into the fubflance
of either organ j there was no other preternatural appearance in the
abdomen ^
\
( 3S )
abdomen j the lungs, and other parts of the cheft, were accuratebf
examined, and found to be in every refpect found, excepting a few
flight adheiions in the right fide.
G II A P. II.
A Defer iption of the Symptoms of Difeafes of the Chef: taken from
thofe Cafes where the Patients recovered, or where the Author had
no Opportunity of examini?ig the Bodies after Death.
§ I. Of the different Kinds of Cough.
Cougb without Expectoration -t or with Expectoration of Mucus only.
THIS cough is commonly moll fevere at firft going to bed, and
is troublefome by fits during the night -, in fome cafes, how-
ever, (though rarely) it is worfe in the day-time. It is accompanied
with difficulty of breathing, fometimes with hoarfenefs, and often
with pains in the chefr. -} but thefe are feldom obferved till the cough
has been of fome Handing. The fits ©f coughing frequently ter-
minate with an expectoration of frothy mucus, which afFords con-
fiderable relief. I have, however, known inftances where that relief
has taken place, feveral hours before the fpitting began. But the
moft remarkable fymptom attending this cough, and which indeed
characterifes it, is, the peculiar kind of fever. After one or two
mivcring fits, or after flight fits of coldnefs and of heat alternately,
which come on in the morning, or a little after mid-day, (fometimes
on
( 39 )
on alternate days only) the heat begins, and continues all the after-
noon, and during the night, and then commonly terminates in profufe
fweating. Sometimes there is no coldnefs nor fhivering, but a con-
tinued heat, which increafes after mid-day.
The pulfe is always quick, generally about a hundred in a minute,
with almdft conflant head-ach, inceffant thirft, lofs of appetite,
frequent retching, and fometimes faintnefs. This cough frequently
is occafioned .by expofure to cold or moifture. Delicate young
women, efpecially when incautious, in thofe particulars, about the
menftrual period, are very liable to it. It fometimes terminates
favourably, but oftener in phthijis pulmonalis ; and may therefore be
reckoned the firft ftage of this difeafe,
Cough, with Expectoration of thick Matter.
This cough attacks alfo by violent fits, commonly in the night,
fometimes in the morning. The expectoration (which generally
begins fome weeks after the cough) is yellowifh, or greenifh, and is
fometimes ilightly {freaked with blood. It is thick, vifcid, and
mixed with a little frothy mucus ; at times foetid, and of a dif-
a'greeable putrid tafle. Its quantity is often not lefs than two or
three pints in twenty-four hours, but it diminifhes towards the end
of the difeafe.
The pains accompanying this cough are of two kinds ; viz. acute
pains in the fides, which frequently precede the firft attack of the
cough, and are often fo violent as to flop it ; or forenefs, in the edges
of the hypochondria, in the upper part of the recti abdominis mufcles*
or in the loins ; which follows the fits of coughing,
In
( 4° )
In fome cafes there is no pain at any period ; frequently there is
fever, though it is feldom preceded by coldnefs and fhivering, nor is
it, in general, fo regular as that which accompanies the cough firft
defcribed. Sometimes, in the laft ftage, there is no fever, the pulfe
being only fixty in a minute. At this period alfo, purging, dropfical
fwelling, or profufe fweats take place ; though ibmetimes none of
*hefe fymptoms occur during the whole courfe of the difeafe. As
die cough abates, the fever, purging, and fwelling abate alfo.
This cough is commonly produced by the fame caufes as the pre-
ceding, but fometimes the caufe is unknown. It frequently proves
fatal in a few months ; but fometimes the patient is, for a number
of years, fubject to fits of it, which continue for feveral months
at a time, efpecially during the winter, and, in women, during
pregnancy.
Cough, ivitb Blood /pit up in fmall Quantities*
This fpitting of blood commonly happens only in the more fevere
fits of coughing ; it is preceded by violent pains of the cheft, and
accompanied with great difficulty of breathing, confiderable fever,
and iometimes fhiverings. The pains of the chefr. are, at times,
increafed by prefTure ; when thefe, and the fpitting of blood, come
on without any evident caufe, they are often removed, in a week or
two ; but when they attack after expofure to dampnefs or cold, they
generally terminate in fpitting of matter, and a fatal phthifis.
When thcfe fymptoms are occafioned by an external injury, the
fpitting of blood feldom continues above a week, and all the com-
plaints ceafe in about a month ; unlefs when it terminates in dropfy,
which
( 4i )
which is fometimes the cafe. As the {pitting diminifhes, it is more
or lefs mixed with a yellowiih matter, and at laft becomes entirely
purulent.
In fome patients this complaint becomes habitual ; continuing for
many years, and attacking chiefly in the winter, or after any violent
exertion.
Cough, with Blood flowing from the Mouth, by Fits.
Frothy blood is brought up by fits of coughing, which are, in
fome cafes, extremely flight ; in others, are violent, immediately
before the blood begins to flow -y the quantity brought up at once is
-about half a pint, or a pint : it is generally pure, but fometimes
mixed with matter. The blood, in fome cafes, flows only twice or
three times during the paroxyfm j in others, much oftener. The
approach of each fit is commonly known by the patient's expecto-
rating more eafily than ufual ; and when coming on, the blood is
felt riling warm in the breafl.
Thefe paroxyfms of haemoptoe are fometimes preceded by a cough
of feveral months continuance, accompanied by an expectoration of
matter, or of blood in fmall quantity, or of a mixture of both ; in
other cafes they fupervene a hoarfenefs brought on by expofure to
cold.
This kind of haemoptoe is accompanied by flight pains of the cheft,
(chiefly about the fcrobiculus cordis) with faintnefs, heavinefs and
drowfinefs, which fymptoms are greatly increafed before each pa-
roxyfm, and are attended with confiderable fever ; the pulfe being
G fometimes
( 42 )
fometimes one hundred and thirty in a minute. Fits of coldnefs,
and of fweating, with ficknefs, retching, and purging, are alfo not
unfrequent fymptoms of this complaint ; which, for the moll part,
terminates fatally, though fometimes in recovery.
A remarkable Injlance of Recovery from a violent /pitting of Blood.
A man, aged twenty-eight, had, for about a week, complained of
pain and fwelling at the pit of the ftomach, and under both hypo-
chondria ; the pain was greatly encreafed by the flighteft preifure,
efpecially on the right fide, by lying on the left, or by a full infpi-
ration : it was accompanied with a trifling cough, but with a very
high fever, the pulfe being commonly about one hundred and thirty
in a minute. In this ftate, he was feized with moft violent fits of
coughing, during which he fweated profufely, particularly on the
upper parts of his body, and expectorated a confiderable quantity of
a thick, brownifh, red, fmooth, or frothy matter. The cough and
fpitting having been almoft inceffant for thirty hours (fome hours
in the night only excepted), the pain of the right lide, and the dif-
ficulty of breathing, decreafed ; the fwelling difappeared, the fever
abated, and the pulfe fell to one hundred and eight -y but, in about
twelve hours, all thefe fymptoms, except the fwelling, returned with
violence, the fits of coughing lafting, with hardly any intermiffion,
for three, four, fometimes ten, and once for twenty hours at a time.
The matter which he expectorated was often extremely fcetid, became
gradually more bloody, and, at laft, in the fits of coughing, he
brought up pure blood in confiderable quantity, and which fome-
times flowed from his mouth, uninterrupted by the cough ; the pain
and fever were always relieved after the fits of coughing and hemorr-
hage, and they increafed after thefe ftopt or abated. About the four-
teenth
( 43 )
teehth day from the mil violent attack of the cough, he began to fpit,
in fmall quantity, a white matter ftreaked with blood. The cough
and fever now decreafed very fenfibly, the pulfe fell to one hundred,
the pain went entirely off, the breathing became eaiy, and, in a
fortnight, lie had gained fo much ftrength as to be able to quit the
hofpital. In a fortnight afterwards,., his complaint again returned
with as much violence as before, and had nearly the fame duration.
Since this time four years have elapfed, during which he has never '
had the fmalleft complaint in the cheft, and now enjoys perfect health
and ftrength.
§ 2. Of difficult Breathing, or Aft h ma.
In this complaint the patients commonly breathe, with a wheezing
or crackling noife, thirty or forty times in a minute, and ftill oftener
after eating, or after the moft moderate exercife. They feel a general
uneafinefs in the upper part of the body, which commonly obliges
them to fit up ; and likewife a tightnefs or pain acrofs the fcrjobiculus
cordis, which prevents them, whether fitting or lying, from ftraight-
ening the fpine, and obliges them to keep the body much bent
forwards ; and fometimes makes them lie with their knees drawn up.
They complain of a fenfe of weight either in one or both fides of the
cheft, or at the pit of the ftomach ; when this laft is the cafe, they
fometimes lie on their face, and when they turn on their back, have
the fenfation of fomething falling from before ; or if they turn to
either fide, of fomething falling from the oppofite fide. They often
awake in a fright. Their pulfe is about one hundred in a minute.
This difeafe is not unfrequently attended by a cough with fpitting, or
by dropfical fwellings ; and fometimes by rheumatifm, It continues
G 2 for
( 44 )
for many years, increafing by fits ; and I have not known it, when
unaccompanied with other difeafes, prove fatal.
Is it not probable, that in thefe cafes there is a fluid in the cavity
of the cheft ? er a luperabundant quantity of fluid in the pericardium ?
or 0 t tins membrane (in c«nfequence of inflammation) adheres to.
the forepart of the. chefl ?
An inftance of difficult Breathing relieved, upon fift 'Tumors
appearing externally. .
A woman, aged fixty, formerly very healthy, after having been
for feveral nights expofed to cold, was feized with great pain and dif-
ficulty in breathing, and with a fevere dry cough, from which (lie
was feldom free above an hour in the day. In about a month from
the beginning of the complaints, a tumor appeared on the left fide
near the lower part of the fcapula ; and, a month afterwards, two
fmaller tumor's were obferved a little above the mamma of the fame
fide : as thefe tumors increafed in fize, her complaints abated, and,
in nine months, when the tumor on the back, nowalmoflhemifpherical,
was larger than a new-born child's head, and each of thofe on the
breaft nearly the fize of an apple. She perceived no difficulty in
breathing, unlefs after exercife, and her cough was feldom fevere :
ilie had fcarcely any pain in the tumors, which felt foft> as if they
contained a fluid, and the fkin which covered them was of the
natural colour. When me coughed, the tumors fwelled, became
hard, and, as me imagined, were in danger of burfting.
In the preceding cafe, was there not an evident communication
between the tumors and the cavity of the cheft ? Is it not probable, .
that i
( 45 )
that matter, formed in the cavity, had made its way through the
parietes ? Could thefe tumors have been opened with fafety, or
advantage ?
A Cafe of difficult Breathing immediately relieved, by, the fpontaneous
D if charge of Matter from the Side.
A woman, aged twenty, received a violent blow with a man's fift
on the lower part of the right fcapula ; me fell down inftantly in-
fenfible, and remained fo an hour : when £he recovered her fenfes,
ihe could hardly breathe, and the part where (lie had been ftruck was
fwelVtd and difcoloured. Three days after the accident, fhe began to
fpit blood by coughing (fometimes in clots), and fhe continued to
do fo for two months, during all which time fhe could not endure
any poflure but laying on her face, refting on her elbows and knees.
In about ten months, the pains in her chefl, and difficulty of
breathing, having nearly left her, her only remaining complaint
being fits,* which came on foon after the accident, and to which fhe
had been fubject ever fmce, me was feized with chillinefs, fhiverings,
cold fweats, fometimes partial, fometimes general, head-ach and
giddinefs, her pulfe was about eighty-four, her fkin itched violently,
and many fmall itchy pimples, and painful bliflers, - appeared on it.
After twelve months, the pain of the right fide again increafed ; in
fourteen months it affected greatly her breathing, and fhe could not
bear even the gentleft exercife, nor lie on the right fide; in fifteen
months, fhe was obliged to fit up conftantly, fupported in bed, and
frequently faid, that fomething was collecting in her right fide,
although there was no fwelling or difcolouration of the part to be
obferved. Towards the end of the fifteenth month, a flight rednefs
appearing
* Probably of the hysterical kind, .
( 46 )
Uppearin^ in one part of the fide, a poultice was applied, and, -in a
few days, matter burft forth, to the quantity, as fhe informed me,
of two quarts ; her difficulty of breathing was inflantly relieved.
Several months after this, me had fevere pains, or flitches, in her
fide near to the wound, which was between the fixth and feventh rib ;
but thefe were removed by the application of a blifter, and the
appearance of many large boils. She has, ever fince this time,
though now four years after the accident, enjoyed perfect health.
§ 3- Of Pa?ns in the Side.
Thefe- pains are fometimes fo acute, and fo much increafed by
infpiration, that the patient dares hardly attempt to breathe. Pie
cannot bear the flighteft prefTure on the part affected, nor, while the
pain continues violent, lie upon that fide ; but commonly lies on his
back, with his head very high. His pulfe is fmall, and about one
hundred in a minute ; with third, and fometimes head-ach. After
the abatement of the pain, there is often a flight cough, without
expectoration ; and a degree of breathlefsnefs, after exercife. The
patient fometimes recovers perfectly in a few days, but fometimes the
complaint lafts from one to three weeks. Thefe pains, in fome
cafes, attack by fits, and then they are of longer duration ; or they
accompany hyflerical fymptoms, but are then feldom fixed. The
caufe of them is frequently unknown ; they fometimes come on from
expofure to cold, and fometimes are occafioned by external violence.
CHAP. III.
( 47 )
CHAP. III.
Obfervattons on the Ejfeff of Remedies employed in the Cure of
Difeafes of the Cheft.
IN difeafes of the cheft I have hardly ever obferved any certain
good effect from internal medicines. Vinegar of fquills, has, on
fome occafions, feemed to give relief to patients affected with cough
and difficult breathing ; and oily medicines, or fpermaceti, appeared
almoft certainly to allay, for a fhort time, violent coughing. But
the remedies which have ftill greater and more lafting effects, are
bleeding, blifters, and other local difcharges ; alfo fomentations.
Bleeding is the appropriated remedy for a cough, and, except in the
laft ftage of confumption, feldom fails to afford very coniiderable
relief, which fometimes is felt immediately after the operation, at
other times not till the next day, or even the third day j and upon
fome occafions, not till after repeated bleeding. This remedy is alfo
of fervice in cafes of difficult breathing, and in pains of the fide ;
although, for the latter complaint, the appropriated remedy is a
blifter, which almoft conftantly gives relief either immediately, or
the day following.
Blifters are likewife of confiderable efficacy in cafes of difficult
breathing, or hoarfenefs, and fometimes of cough. Setons or iffues
are ufeful in pains of the cheft -, and fomentations are of fervice in
pains occafioned by external injury. From the early application of
thefe remedies, pains of the fide frequently, and dry coughs, fome-
times, terminate favourably ; but if they are delayed for a week or a
fortnight,
( 43 )
fortnight, the difeafe does not yield to them, but feems to keep on
in its natural courfe.
In cafes of cough with expectoration, and of difficult breathing, or
afthma, thefe remedies feem to afford only a very tranfitory relief,
and to contribute but little towards retarding the progrefs of the
difeafe. Thofe diforders, therefore, which are the moft common,
and the moil fatal of any, are unfortunately leaft under the power
of phyfic. I have known good air of fervice in fuch cafes, after
bleeding had failed to afford, even a temporary relief.
PART IIL
( 49 )
P ART HI.
Difeafes of the Fluids,*
CHAP. I.
Difeafes of the Fluids, illufl rated by DiJJ'etfion.
% I. Extravafation of the Serum, or thinner Part of the Blood.
A WOMAN, aged twenty-three, who had never menflruared,
and, for many years, had been in a bad ftate of health, but
without any particular complaint, became anafarcous about fix weeks
before her death. She had no cough, nor was her breathing labo-
rious, although fiie frequently fat up in bed, and fpeaking was trou«
blefome to her : fhe only complained of the fwelling of her* body,
and of weaknefs of her eyes. She died quietly, and rather unexpect-
edly, in the night,
A tranfparent yellow fluid was found in mcft parts of the cellular
membrane, a fimilar fluid in the abdomen, and a more than ufual
quantity of fluid in the pericardium, which adhered by a broad furfice
to the ribs and pleura of the left fide: the lungs of this fide, on
firft opening the thorax, were not vifible, but after feparating ^he
pericardium from the ribs, and drawing it forwards, they were {sen.
H firmly
* I chofe this title, not from any idea that the difeafes defcribed under it were
•difeafes of the fluids only, and that the folids were not likewife affected ; but becaufe
the changes which took place in the fluids were evident to the fenfes, whilft thofe of
the folids were not.
o
Li: RY
( 50 )
firmly adhering to the poflerior part. They were intirely red, not
more than three inches broad, thin in proportion, not divided into
lobes, not veficular, every where hard, and, at each extremity, nearly
of a tendinous confidence, and adhering fo firmly to the ribs,,
that they could not be feparated from them by pulling : the lungs,
in the right fide adhered likewife to the parietes, in other refpech
were found, as were the abdominal vifcera.
As anafarcous fvvellings fo frequently accompany difeafes of the:
lungs, is it not probable, that they have fome dependance on the
ftate of this organ ?
§ 2. Extravafation of the red Part of the Blood.
A woman, aged fifty, who, a fortnight before, had been feized
with- a fever, of which fhe could give no diftincl: account, complained
(the fever ftill continuing) of pains all over her, and red fpots ap-
peared on her arms, breafl, and legs : fiie was cofKve, her tongue
parched, and covered with a black cruft, or Hough ; her pulfe,
fmall, but not very quick ; fhe was at times delirious, and often
quite fenlible. The colour of the fpots becoming gradually darker,
and her pulfe finking, fhe died about the nineteenth day of her illnefs.
Forty hours after her death, we examined the body, when,
befides red and purple fpots, of about a quarter of an inch diameter,
which were very general on the furface, particularly of the ex-
tremities ; there were alfo fome blue blotches. The purple fpots,,
viewed with a microfcope, appeared of an uniform colour, whilffc the
red fpots, which were broader, feemed a congeries of minute fpecks
and ramifications. The cuticle, feparated from the fkin by boiling
water t
( 5' )
•\vater; was found not in the leafl affected by the fpots, which
appeared more diftinct after its removal : they were confined entirely
to the fkin, though only viiible on its external furface ; and they
difappeared altogether, when, after removing the cuticle, the fkin
was macerated in water. Sometimes, immediately under the fpots,
there were fmall effufions of blood in the cellular membrane ; and,
under the blotches, both this membrane and the fat were en-
tirely red ; but the mufcles never were affected. After having very
carefully and fuccefsfully injected one of the arms, no extravafation
of the injecting fluid could be perceived, either on the fkin, or in
the cellular membrane ; nor could we fee any extravafation or en-
largement of vefTels on a piece of the fkin, which had feveral fpots,
when injected and dried. The vifcera of the thorax and abdomen
were found : in the cavities of the heart and large blood-vefiels,
were found fmall but not firm polypi. A bit of the black emit,
or Hough, taken from the tongue and macerated for fome days in
water, tinged it red : what remained was a white mucus, readily
diffufible in water, and fomewhat refembling moiftened bread.
As there was no extravafation to be difcovered after a very minute
injection, is it not probable that the extravafation of the colouring
part of the blood, in the preceding cafe, was more owing to the Hate
of the blood than to that of the blood- vefTels?
§ 3. Extravafation of coloured Serum, &c*
A man, aged twenty-four, was fuddenly feized with fhivering,
which, after returning two or three times, was followed by the
fymptoms of fever ; he complained chiefly of heat, flept much in the
day ; in the night was often delirious : his pulfe was quick and fmall,
H 2 his
( 52 )
h.s tongue dry, but not foul -y he had two or three ilools a day, and I
his urine let fall a copious cream-coloured fediment, refoluble by heat.
On the feventeenth day, he felt a pain in the lower part of his thigh,
which, on the twentieth, was greatly increafed, and extended down the
outfide of the leg ; the parts affe&ed were red, and fomewhat fwelled :
his tongue was parched, and his pulfe fuller than before. On the
twenty-fourth, the limb had become in part livid, the leg and foot were
greatly fwelled and painful -, his countenance was pale, his tongue
black, his pulfe fluttering : and, on the twenty-fifth^ the day of his
death, the cuticle was raifed in bliflers, the leg having exactly the
fame appearance as it had . two days after, when the body was
examined.
The lower part of the right thigh was, on the outfide, red, or
livid, and covered with fmall bliflers, containing a red liquor; the
lower part of the leg and foot, of the fame fide, were very much ..
fwelled, ' and, on the outfide, which was of the fame colour with the
thigh, there was a great blifler, from which, before death, two
ounces of a tranfparent red fluid, without fmell, were taken. On
the right arm, was a flight livid fpot. In the veins of the pia mater, ,
we found blood and air alternately interpofed. The fluid in the lateral :
ventricles, was reddifh, and coagulated Hightly by heat. The liquor
taken from the leg being immediately mixed, in different proportions,
with water, gave it a red tint, the mixture remaining tranfparent ;
but, next morning, there was either a white cloud formed, a fur
adhering, or a fediment depoflted : the fame liquor unmixed with
water, fuffered no change 'till the fourth day, when it alfo let fall a
fimilar fediment ; but it flill, and for feveral days afterwards, re-
mained tranfparent : it was coagulated by heat almofl as firmly as the
ferum, a fmall quantity of an aqueous fluid remaining.
Did
( 53 )
Did not the firm coagulation, by heat, of the extravafated fluids
/hew that it was chiefly ferum ? Did not the admixture of the red
part of the blood with this fluid, and with the lymph of the lateral
ventricles, fhew a tendency to putrefaction ?* although, as there was
no difagreeable fmell, this could hardly be faid to have taken place.
Was not the air interpofed between the portions of blood in the veins
of the pia mater, a further evidence of this tendency ? for I have,
on other occafions, remarked, that large veffels which paffed near an
internal putrid ulcer, contained, in like manner, portions of blood,,
and of air,, alternately.
§ 4. Putrefaction of the- Fluids,
A woman, aged twenty, was feized with fhiverings,. followed by
fever ; fhe became dull, heavy, flupid, and fometimes delirious : me
had a violent purging, her tongue and eyes were parched, her pulfe
quick and fmall, and there were petechias on the right arm ; fhe was
quite neglected 'till the tenth day of her illnefs -y fhe died on the
eleventh, and, immediately after death, a change of colour took place
in the body. .
This difcolcuration was principally on the right dde,. from the
breaffc to the middle of the thigh, and from the linea alba to the
fpine; the upper and lower parts, and belly, were green, the back
liyid, and the pudenda quite black : at incifions made on any of thofe
parts, a confiderable quantity of a muddy liquor, nearly of the
fame colour with the part, run out : it was fo intolerably fcetid,
that a man had almofl fainted from fmelling to it; the parts
from which it flowed were tender, and eafily pulled afunder. In
the pudenda, the blacknefs penetrated to the cellular fubftance
and.
( 54 )
-and fat, but it did not extend inwardly beyond the nymphas, and
backwards not quite to the anus ; the green colour of the abdomen
penetrated through the integuments, the fat, and the oblique mufcles j
but the recti, tranfverfe mufcles, and peritoneum, were free from it.
The livid colour of the back penetrated almofl to the bones, near
which the mufcular fibres appeared found ; there were a few red
fpecks on the arm and bread of the right fide ; nothing preternatural
appeared in the cavity of the abdomen, except one black fpot on the
fundus uteri.
After having vifited this woman, I became for a minute, blind,
ftupid, and confufed, but I fuffered no inconvenience either during
the diiTection, or afterwards. One drachm of the putrid liquor re-
ceived at the incifions, was, an hour afterwards, along with three
drachms of water, injected into the crural vein of a healthy bitch,
who was giving fuck : in a minute me vomited ; in an hour all her
limbs trembled, and in an hour and a half fhe feemed in the greatefr.
uneafinefs, whilft her puppy, who had given over fucking, was
making a noife : me frequently vomited during the day, and in the
night j next day, when called to, Hie moved flowly and feebly, and could
hardly keep her eyes open ; her hair flood on end, and me refuled
taking food 'till the evening, from which time flie gradually
recovered.
Twelve hours after death, I examined the body of a young man
who died of a fever refembling the preceding. The fkin of the left
bread was brown, and the pectoral mufcle had loft its colour and was
rotten ; the liver, likewife, was in fo tender a ftate, that a very fmall
force was requifite to pufh the finger into any part of it. The other
abdominal vifcera appeared found.
Soon
( 5S )
Soon after examining this body, I felt an acute pain at the end of
the finger which I had pufhed into the liver j it inflamed : a fmall
piece of it near the nail became black and mortified, and, after a
few days, was thrown off by fuppuration.
Are dullnefs, ftupor, and lownefs of pulfe, the criteria of this
fever, or of a tendency to it ? Is infection more readily communicated
from the living than from the dead body ? May an external part of a
healthy body be affected without injuring the reft of the fyftem ? If the
putrid matter has been mixed with the blood, will a putrid fever
always follow ? Is there a connection between this and the petechial
fever ? From the external parts being principally affected, is it net-
probable that the air has fome influence in promoting the putrefaction ?
Would not the external application of antifeptics have an effect in
retarding this procefs I
§ 5 . Extravafation and PutrefaBion, united in the fame SubjeSf,
A woman, aged fifty, who, though addicted to the ufe of
fpirituous liquors, was healthy till four years before her death,,
when fhe was feized with pains of the cheft, cough, and difficulty
of breathing, which going off in a few months, me continued well
for three years : her complaints then returned, and, for two months,
were accompanied with a very copious difcharge of thin faliva ; foon
after the flopping of which, fhe became generally oedema tous.
During a few months In the fummer, the fymptoms were moderate,,
but, four months before her death, they were more violent than
ever ; her breath being very fhort, obliged her to fit up almoft con-
stantly -, for, when lying, fhe was in danger of being fuffocated ; fhe
could utter but a few words without flopping j her cough was very
troublefome, and, in the fits of it, her face, which was at all times
bleated.
( 5« ')
bloated, became purple ; me often performed all the motions of
coughing, without uttering any found ; me was thirfly, her tongue
dry and whitifh ; her pulfe about one hundred -, her urine de-
pofited a copious fediment, like powdered bark, the liquor above
refembling diluted claret. The fwelling was univerfal, but the lower
extremities were fo much diflended, that they could hardly be moved.
The belly being alfo greatly diflended, fhe was tapped, and feveral
gallons of a greenifh liquor, by this means, were evacuated. After
the operation, (he was, for feveral days, much relieved ; but, on the
fixth, having had a violent fit of fhivering, fhe died fuddenly.
In the month of February, thirty-four hours after her death, I
examined the body. It was generally fwelled, with red fpecks and
purple fpots on feveral parts of the furface j the latter, about one third
of an inch in diameter, penetrating quite through the fkin, were
owing to extravafated blood. The face was of a deep purple; on
the breaft were long, ramifying, red vibices ; a portion of the cuticle,
on the infide of the thigh, was raifed in a blifter, containing a thin,
reddifh fluid, and, for a confiderable way round the blifter, was
eafily feparable from the true fkin : in the abdomen, were feveral
quarts of a reddifh muddy fluid, in fome degree coagulable ; the
contents of this cavity were found ; the liquor pericardii was reddifh ;
the lungs every where adhered, by a cellular fubflance, to the neigh-
bouring parts, and, though there was no particular hardnefs, or
tubercle, to be feen, they were not quite fo foft as in a found ftate -9
air blown in at the windpipe efcaped, and diflended the cellular fub-
flance on their furface ; the fame thing happened, when, in a portion
of the lungs cut off, air was blown in at a branch of the windpipe, or
pulmonary vein : when the pulmonary artery was blown into, its
fmaller branches were alone diflended ; a black fubflance accompanied
the
y
( 57 )
he vefTels in their courfe, and appeared, upon a tranfverfe fection,
like a black circle furrounding them.
Was the want of found in coughing owing to the air, in the time
of that action, efcaping from the veficles into the cellular fubftance ?
Is this, therefore, a fign of ruptured velicles ? Did the copious dis-
charge of faliva, in the beginning, mew a feparation of the thinner
fluids j which, upon the flopping of that difcharge, were depofited
in the cellular membrane, and in the abdominal cavity ? Did the
purple colour of the countenance, the fpots and vibices, mew that
the red part of the blood was broken down, and entered vefTels
which, in a found ftate, it could not do ? Did the colour of the
urine, of the liquor in the blifler, abdomen, and pericardium, ihew
a folution of the red part of the blood in the thinner fluids ?
Do the fluids in cavities fometimes acquire a red tint, either a few
days before, or a few days after death ? Was the difeafed ftate of the
fluids, in the preceding cafe, to be imputed to the affection of the lungs,
to the ufe of fpirituous liquors, or to both ?
In differing the body lad mentioned, having broken the ribs
that the lungs might be more fully feen, the pointed fplinters of them
punctured the cuticle on feveral of my fingers, efpecially of the left
hand. On returning home, about an hour after, I was feized
with miverings, wearinefs, and pains all over my body : towards
evening I had a violent head-ach, and fome degree of fever; but next
morning awoke perfectly well. The wounds did not heal up,
but became red, fwelled, and, though not very painful, for
feveral months gradually increafed. Having the fame day, imme-
diate^ after examining this body, examined the body of a man who
had had a veneral complaint, it was fuppofed that from the latter,
the injury might perhaps have been received : I, therefore, made trial
I of
( 53 )
of a variety of mercurial applications, after each of which the tumors
became larger, redder, and more painful ; they were then burnt down
by lunar cauflic, but always grew up again, and, at laft, had the
appearance of warts, with their bafes fwelled and red. In lefs than
a twelvemonth after the accident, there appeared on the back of
the left hand, where there had been no wound, a fmall, moveable,
round tumor, refembling a lymphatic gland, which gradually in-
creafed ; the lkin became livid, and there were fometimes flight
mooting pains in the part. Soon after the appearance of this
tumor, the glands in the left armpit fwelled, and became, in
fome degree, painful -y the glands of the fame fide, under the lower
jaw, alfo fwelled, and feveral fmall fores broke out upon the tongue
and inlide of the mouth ; foon afterwards the glands alfo of the right
armpit fwelled. Being at a lofs how to flop the progrefs of fo
uncommon an affection, I began to take mercurial medicines, in
comiderable quantity, which I had feveral times employed before,
though fparingly : at laft, I underwent a falivation by unction ; but
never obferved, during this courfc, nor for a confiderable time after
it, the fmallefl favourable change upon the tumors on the hands,
the fwelled glands in the armpits, or the fores in the mouth ; I,
therefore, fubmitted to have the tumors removed by the knife,
feveral of which growing up again, were repeatedly cut off. The
fores, while healing up, never had a good appearance, but were
floughy, and fometimes very painful. In about a fortnight, after
the laft remaining tumor had been cut off for the fecond time,
and about two years after the wounds had been inflicted, the fwelhng
of the glands fubiided, the fores in the mouth healed up, and have
not (though it is now almofc three years) in any degree returned.
CHAP. II.
( 59 )
CHAP. II.
A Defcription of the Symptoms of the Difeafes of the Fluids, taken
from thofe Cafes where the Patients recovered, or where the Author
had no Opportunity of examining the Body after Death.
§ i. Swelling of the Belly, with Fluctuation,
THIS fwclling fometimes occurs alone, but raoft commonly it is
attended with external, or cedematous fwellings. Women are
chiefly fubject to it from obftrucftion in their menfes, or during preg-
nancy, in which cafe it continues after delivery. It happens to
psrfons of either fex after a cold, cough, or fever, and fometimes
without any difeafe preceding it. It is accompanied with difficult
breathing, cough, thirrr., a diminution in the quantity of urine, and,
at times, with fever. The patients, in general, have a faded, or
fallow complexion, though fometimes they retain a ruddy and healthy
appearance. I have known this complaint continue five years, with-
out caufing any confiderable uneafinefs ; but when the fwelling has
reached its utmoft extent, the condition of the patient is truly
miferable : obliged to lean forward, the belly fupported by pillows,
tormented with violent pain in the bowels, and with bile forced
up into the mouth almofl every minute. This difeafe is frequently
relieved, or carried off, at leaft for a time, by fpontaneous purging ;
fometimes by fpontaneous fweating. When it returns, as it fome-
times does, feveral times in a year, it terminates fatally.
Might not fudorifics be tried in thofe cafes where purgatives have
filled ?
I 2 § 2. General
( 60 )
$ 2. General external Swelling, retaining the Imprejfion of the
Finger*
This fwelling is more remarkable in the lower, than in the upper
parts of the body, and is frequently more confiderable in the right than
in the left fide ; the parts affected, are, fometimes, though rarely,
tender and painful to the touch. This complaint is fometimes unpre-
ceded by any other, or it follows after ficknefs and indigeftion,
fudden fuppremon of the menfes ; and frequently after a cough, or
fome other affection of the cheft. It is commonly accompanied by
difficult breathing, thirft, and paucity of high-coloured urine, be-
coming turbid when cold. Perfons of very different ages, from
twelve to fixty-two, are fubject to this difeafe : fome have the
countenance bloated, others have a fpontaneous and very confiderable
bleeding at the nofe -f in either cafe, and not otherwife, the difeafe
terminates fatally.
§ 3. General external Swelling, wltb Swelling of the Belly.
The union, or combination, of thefe complaints, is to be met
with mod commonly in perfons naturally of a weak or unhealthy
conftit .on, the external fwelling almoft constantly precedes the
fwelling of the belly ; they follow from the fame caufes, as when
fingle or alone. I have known them happen, and to a high degree,
in a fortnight, after a bruife on the cheft. They are accompanied
by the fame fymptoms as § 1. and § 2. often with faintnefs and
lownefs ; fometimes with vomiting of blood, or purple fpots on
the
( 6i )
the fkin, both fatal fymptoms. They fometimes terminate favourably
by a fpontaneous purging, increafed difcharge of urine, or a flow of
thin fluid from the falivary glands.
Is not either fpecies of dropfy commonly a fecondary difeafe ?
Is it not evident, from the bleeding at the nofe, vomiting of blood,
and purple fpots, that the red part of the blood is broken down, or
the blood- veflels weakened ?
Should not the view of the phyfician be directed rather to the
amendment of the fluids and folids, than to the evacuation of the
former ?
Is it likely that this amendment may be attained by animal food
and Peruvian bark ? r
When the evacuation of the fluid is necefTary, and when purgatives,
diuretics, and fudorifics have failed, might we not imitate nature,
and excite a falivation ?
§ 4. A fluctuating Swelling on the Loins.
A man, aged thirty-two, having been thrown down on his face,
the narrow wheel of a loaded cart went directly acrofs his loins from
left to right ; he was carried home, neither wounded nor in pain ;
and, though benumbed in the loins, he walked in the evening. For
fome days he complained of pain in his bowels, and had no ftool.
The day after the accident, we obferved a fluid collected under the
integument of the loins. In a fortnight, the integuments were greatly
fwelled,
( 62 )
f welled, and an evident fluctuation was felt on ftriking the tumor.
In a month, the fluid having fpontaneouily decreafed, did not fill the
cavity which it had formed, and by change of pofture, or upon
prerTure, it moved from place to place, the patient himfelf being
fenfible of its motion, as he had been before of its fluctuation. The
cavity, at this time, extended from the os coccygis, feven inches
upwards ; and from the left great trochanter to within a few inches of
the fame tuberofity on the right fide. In two months, the fluid had
almofr. wholly difappeared, and the integuments having become firm,
adhered to the parts underneath. In a few weeks more, he was free
from complaint.
N. B. Fomentations had been employed.
§ 5. Fever, with red, or purple Spots on the Skin.
This difeafe commonly begins with a fit of mivering, which fome-
time3 returns, and is always followed by fever. The patients, in
general, take to their beds in the beginning, although they fometimes
go about for three or four, or even nine days, uncertain of the nature
of their complaint. The fpots appear, at different times, from the
fifth to the tenth day, and are either very fmall, of a deep red or
purple colour ; or larger, about one quarter of an inch in diameter,
and of a paler red : both kinds frequently appear in the fame perfon ;
the former chiefly on the extremities, the latter all over the body.
The breathing is laborious, and fometimes accompanied with a fnorting
noife. The eyes are red ; the tongue and lips parched, or chopped,
and covered with a black, tough, femi-tranfparent cruft ; which, by
maceration in water, becomes at firft gelatinous, and afterwards of
the confluence of fyrup. Sometimes blood is effufed on the tongue,
and
( H )
and hardens on its furface. The pulfe feldom exceeds one hundred
in a minute, fometimes flower ; it is low, and ftrikes the finger fo
"radually, that it feems rather to prefs upon than ftrike it : it fre-
quently intermits. The patients complain of pain, or of noife in the
head, and of general uneafinefs ; they are dull, and fo drowfy, that
. they can hardly keep their eyes open ; they are fometimes fenfible,
but more commonly delirious, efpecially in the night, when, unlefs
prevented, thay frequently get out of bed, but are not outrageous,
and are eafily prevailed on to return again to bed. The liquor
difcharged by blifters, though of a dark brown colour, is free
from fmell. The ftools are fometimes of the fame colour, and the
urine deposits a ipongy, fometimes reddifh fediment, in fmall quantity,
there is feldom any tendency to fweating, but very often to purging,
the fick having commonly four or five ftools in twenty-four hours ;
end it is difficult to determine, whether this evacuation be hurtful, or
ferviceable. An abatement, or relief of the fymptoms, commonly
happens on the fourteenth day, feldom fooner ; frequently not till
about the twentieth. For feveral days after the abatement of the
fever, the patients are often troubled with a dry cough, and fome-
times become deaf. Of ten patients whom I faw in this fever, two
died : the firft, who had a mod violent purging, died on the fixth ;
and the lecond, who was coftive, died on the twenty-fecond day. This
fever appeared, in fome inftances, to have been communicated by
infection.
Did the fpots, the blood effufed and concreted on the tongue ; the
colour of the liquor of the blifters ; that of the ftools, and the
fediment of the urine ; mew that the red part of the blood was
broken down ?
CHAP. III.
( 64 )
CHAP. III.
Obfervations on the Effects of Remedies given in the Cure of
Difeafes of the Fluids.
§ i . A general Account of thofe Effects.
IN the fpotted fevers, inftances of recovery were moft frequent after
the ufe of bark, of cordials, and of blifters. The fwelling of the
belly, or of the external parts, in general, fubfided, though com-
monly only for a time, from the ufe of the more powerful purgatives ;
viz. jalap, elaterium, and dried fquills, given either feparately or
combined. Alfo during the ufe of diuretics, as nitre, the fal diu-
reticus, infufion of horferadim, and tincture of cantharides. The
fwelling of the belly con flan tly returned after tapping, and fometimes
the patients died very foon after this operation. The puncturing the
legs was likewife attended with danger, and, in one cafe, the limbs
inflamed, became black, and the patient died in three weeks. As
evacuations then are mofl commonly ineffectual, and even dangerous,
a medicine is greatly wanted which would produce fuch a change in
the parts, as after abforption to prevent the further extravafation of the
fluid. The two following Angular inftances of the happy effects
produced by mercury and bark, may poffibly fugged fome ufeful
hints on this important fubject.
§ 2. The Effect of Mercury in an objlinate Swelling of the Limbs.
A young woman having, on the day her menfes began to flow,
taken imprudently, whilft hot, a draught of cold water, the difcharge
immediately
( 6j )
immediately flopped ; her legs inflamed and fwelled ; and me was
feized with fhiverings> followed by fever and pains all over her body -t
after two or three weeks, the fits of fhivering, fucceeded by fever,
frequently returned again, and at thofe times the inflammation of the
legs increafed. In about a year, the whole of the lower extremities
had attained an enormous fize ; but the fwelling was not now at-
tended with inflammation ; on the contrary, the limbs were cold and
hard : it differed alfo from the oedema, as it did not retain the im-
preffion of the finger ; nor was fenfibly increafed towards evening. In
every other refpecl, excepting a diminution of the catamenia, the patient
feemed to be in perfect, health. Notwithftanding the ufe of various
medicines, and the application of cauftics and blifters, which laft, by
the bye, occafioned no difcharge, her limbs remained in the ftate
above defcribed for almofl two years and a half ; fhe then began to
rub on her legs the mild mercurial ointment, gradually encreafing
the quantity to half a drachm, afterwards to one drachm every night -3
fhe lived low, and the limbs were kept in a horizontal poflure. In
three weeks, the fwelling having fubfided, the legs were foft and
flaccid ; and, in three months, the fkin was fo loofe, that it feemed
probable, that what had formerly diflended it, was nowmoflly abforbed.
Her mouth was but little affe&ed ; her bowels not in the leaft : fhe
fweated much, and made water in confiderable quantity.
§ 3. The Effeff of Bark in a copious Difcharge of putrid Sa/iza,
A woman, aged thirty-eight, after feveral irregular fits of coldnefs,
fucceeded by heat and fweating, was feized with a fwelling of her
cheeks, which externally were tenfe and mining, and internally were
covered with a firm white cruft, or flough, above half an inch thick,
and which was totally infenfible when cut through with a knife ; the
K palate
( 66 )
palate and gums were alfo covered with a fimilar flougk ; the tongue
was almoft unmoveable, fo that her fpeech was feldom intelligible,
and the teeth could not be brought in contact, owing to this cruft
projecting between them : there was, day and night, a continual
difcharge from the mouth of a vifcid, ropy fluid, frequently bloody,
and fo abominably foetid, that it was difagreeable to come within
feveral yards of her 5 the quantity difcharged was about four pints in
twenty-four hours. The fluid fpontaneoufly feparated into two parts :
the one a thinner j the other a more vifcid and heavier ; the former
not at all, the other only partially coagulable by heat ; the patient
could fwallow only the thinneit liquids, and even thefe with difficulty:
{he had no appetite, but had ddly four or five loofe ftools : her pulfe
was very fmall, between one hundred and fix, and one hundred and
twenty. To this miferable condition fne had gradually arrived ;
when, on the twelfth day of her illnefs, flie began to ufe the bark in
the following manner :
R. deco£L corticis pcruv. unciani unara.
Tin<St. cjufdem, drachmas duas.
Quarta quaque hora fumendas.
In four days the difcharge was thinner, and lefs ofrenfive ; fhe had lefs
difficulty in fwallowing, had fome appetite -, her pulfe was flower,
her purging had flopped, and the cruA began to fall off from the
angles of the mouth ; continuing to recover, me, in a few days
more, began to have pain in her cheeks, which before were in-
fenfible ; afterwards in her tongue ; and, laftly, in her gums and
teeth •> the agony of which was fometimes lb great as to prevent her
fleeping. When the cruft had fallen off from the gums, they ap-
peared puihed out in the form of papillae. On the twelfth day, after
fhe began to take the bark, her face, outwardly, had almoft. its
natural appearance ; the cruft had fallen off entirely from the cheeks,
palate,
( 67 )
palate, and gums, the papillas of which had alfo fubfided, and there
was but little of it now remaining at the root of the tongue : fhe
could bring her teeth clofe together, could move the tongue a little,
and fpeak more difKnclly. The difcharge, now far lefs copious and
lefs foetid than formerly, did not flow conftantly, but, being col-
lected in the mouth, was fpit out ; fhe had hardly any pain, could
fwallow folid food, was colli ve, and her pulfe between eighty and
ninety. In a few days more the difcharge flopped entirely, and, in
a few weeks, fhe had no complaint but fliffnefs in the parts, which
prevented her from opening her mouth, or putting out her tongue
freely 3 and fome months afterwards, being perfectly well, fhe went
into the countrjr»
X 2 PART IV.
i <>* )"
PART IV.
Dijeafes of the Head; Nerves, and Mufcles.
CHAP. I.
Difeafes of the Head, &c. illufiratcd by DiffeBion.
§ i . Lymph lodged between the Dura and Pia Mater.
A STOUT man, aged twenty-three, was fuddenly feized with a
fever, accompanied almon: conftantly with violent delirium.
When brought to the hofpital, he walked about nearly as a perfon
in health, and anfwered fome queftions fenfibly ; but the anfwers he
gave to others, and a certain wildnefs in his look, difcovered the
dangerous ftate he was in. As he could not otherways be kept in
bed, he was bound with broad ftraps of leather ; his face and eyes
were red, his pulfe neither quick nor full ; he always faid he was
very well, that his giddinefs had gone off, and complained of his
confinement. Every night, and frequently during the day, he was
noify and ungovernable, tearing whatever came within his reach.
On the night but one preceding his death, he broke the ftraps, got
out of bed, and it was with difficulty that three men could again lay
him down. Pie then fweated profufely, his pulfe funk, his f:.ce
became pale, his voice changed to a doleful cry ; and, in a few
hours afterwards, on the morning of the ninth day, he expired.
A woman,
( 69 )
A woman, aged fixty, was feized with a fever, accompanied alfe
with violent delirium : when afked how fhe did, me commonly
anfwered fhe was very well, excepting towards the end, when fhe
complained of her head ; fhe was noify in the evening, and during the
night, and it was with difficulty that fhe could then be kept in bed.
Her pulfe was quick, and fometimes intermitting ; her eyes red, her
lips black : at laft, her face having been frequently diftorted, and
her arms fometimes convulfed, fhe died on the thirteenth day.
A flout man, aged thirty-two, after feveral fits of fhivering, was
feized with a fever, accompanied with violent delirium, though lefs
conflant than in the . preceding cafes: he was fometimes fenfible
during the day, and complained greatly of his head ; he was out-
rageous on particular nights only ; his eyes were red, and his pulfe
quick. He died on the eighteenth day.
In the three preceding cafes, after the fcull had been fawed
through, on cutting the dura mater* and inclining the head, a thin
colourlefs liquor, not coagulable by heat, run out, to the quantity
of about two ounces, in the firfr. cafe ; of about an ounce and a half
in the fecond; and of about half an ounce in the third. After the
upper part of the fcull had been feparated from the dura mater, on
railing this membrane, a fmall quantity of lymph was obferved
lying between it and the pia mater ; and, after the brain had been
removed, the medulla oblongata and fpinal marrow appeared fur-
rounded with lymph. In the firft cafe, there were no other preter-
natural
; We were 3cd to perform this part of the difle&ion with caution, having formerly
found lymph in the encephalon of a man, who before death had fimilar fvmptoms, but
v/hofe head was not opened fo carefully as to enable us to give an exad defcription
cf it.
( 7° )
natural appearances in any part of the encephalon ; in the fecond and
third cafe, there was a fmall quantity of lymph effufed between the
convolutions of the brain, under the pia mater ; and, in the fecond
cafe, there was rather more than the common quantity of lymph in
the lateral ventricles.
Are outrageoufnefs, and inTenfibility to pain, characterifKcs of this
fpecies of fever in its highefl degree ? From the violence of thofe
fymptoms being nearly in proportion to the quantity of lymph effufed,
is it not probable that they are occaiioned by the preflure of that
liquor upon the brain ?
§ 2. Suppuration of Part: of the Dura Mater J*
A woman, aged thirty-four, ftooping to avoid a beam of wood
which a man carried on his ihoulder in the ftreet, was ftruck by it in
the upper and fore part of her head fo violently, that fhe fell backwards :
lhe, however, got up again immediately, and, after wiping off fome
blood which came from the wounded part, walked feveral miles : fhe
alfo next day walked feveral miles, but complained that the cold ftruck
like a knife through her head. On the fourth day, fhe came to the
hofpital, when a tumor, which had rifen about the wound, was laid
open, and a fracture fearched for, but none was found. Though
fenfible, fhe fometimes ftarted and looked oddly. In the evening a
delirium came on, and fhe was noify a great part of this, and for many
fucceeding nights. During the day alfo fhe was frequently infenfible
and delirious, efpecially on the tenth and the three following days ; fhe
often complained of exquifite pain in her forehead, which fhe would
Hot fuffer to be touched ; fhe alfo complained of weight and op-
preflion*
* ftg. xu
( 7> )
predion, and always cried out at the dreiling or enlarging of the
wound : her face was often diflorted, and her limbs convulfed ;
fometimes (he trembled, and frequently ftarted when fpoken to : the
pulfe was feventy, and pretty regular. On the fourteenth day the
delirium had greatly abated -, fhe became almoft conftantly fenfible of
her pains, and was apprehenfive of danger ; on hearing the leaft noife
me ftarted, and faid it was like thunder in her ears : the pulfe was
between lixty and feventy. On the morning of the feventeenth, fhe
had a fit of fhivering, which returned afterwards, four or five times,
at irregular periods : it was followed by fever and fweating : the pulfe,
during the fever, varied from one hundred, to one hundred and thirty,
according to the violence of the fit, and the fiiortnefs of the interval
between it and the time of examining the wound. About the twenty-
firft the delirium went off entirely; fhe was dull, drowfy, kept
her eyes fhut, and feldom fpoke j fhe afterwards became gradually
weak, apt to faint when fitting up to have her wound dreffed : the
pulfe funk ; and, on the twenty-eighth day, after receiving the blow,
fhe expired.
The contiguous furfaces of the difeafed part, both of the dura
mater and of the cranium, were each of them moiflened with a little
purulent matter -3 but the bones were fmooth, and, in every refpecl:,
found. The internal furface of the dura mater, oppofite to the
difeafed part ; the falx, and the two lower fides of the longitudinal
finus, appeared quite found, but the internal furface of the upper fide
of that finus, was of a light flraw colour, fmooth, and, when held
oppofite to the light, did not feem thickened. All the other parts of the
membranes of the brain, and of the cerebellum, were carefully exa*
Hiined, but we met with no other preternatural appearance.
Where
( 7* )
Where the reflexion of the dura mater forms the falx, is there any
cellular fubftance in which pus may be formed and collected ? Does
matter collected there, make its way more readily through the ex-
ternal lamina of that membrane to the bone, than through its internal
lamina to the brain ? In the preceding cafe, was there no matter
formed till about the feventeenth day, at which time the delirium went
off, and the fhiverings began, which were foon followed by drow-
finefs ? If fatal confequences arife from a few drops of matter in the
head, what have we to apprehend from a larger quantity of this, or,
probably, of any other fluid, collected there.
§ 3. The Veins of the Pia Mater apparently enlarged.
A man, aged twenty-three, after having been drunk and riotous
in the ftreets for two nights, was feized with pains, particularly in
his head, attended with fever : he fweated in the beginning. On
the fourth, and fome following nights, he was delirious, though not
unmanageable : during the day he was fenfible, until the feventh,
after which he appeared quite ftupid, and his eyes, both day and
nighty were open and fixed -, his body at firft coftive, was now loofe,
and his ftools and urine came away involuntarily ; he fweated pro-
fufely, and died quietly on the eleventh day.
In fawing the fcull rather haftily, the veins of the pia mater, which
terminate in the longitudinal finus had been, as we afterwards found,
cut through, and about two ounces of blood had run out ; yet thofe
veins, when the cranium and dura mater were raifed, appeared ftill
diftended with blood, and greatly enlarged. The other parts of the
encephalon were examined, but nothing preternatural was feen. The
lungs and heart were in a found ftate.
§ 4- M
( 73 )
§ 4- -ZVb morbid Appearance in the Brain after an Apoplexy,
A flout healthy man, aged thirty-one, who in the morning went
out perfectly well, in the courfe of the day complained of giddinefs
and head-ach. In the evening, when walking with fome com-
panions, he flopped fuddenly, faying, that his head-ach and giddinefs
were fo great he could not go on. He immediately leant to a
fide, was violently convulfed, and, though his friends ran to his
affiflance, fell to the ground' fpeechlefs and infenfible. Twenty-
four hours after the attack, he lay on his back, breathed high, with
a fnorting noife ; his face was turned to the right, his mouth and
nofe drawn a little to the fame fide, and froth ifTued from his mouth ;
his eyes were fhut, whilfl tears ran from them j his pulfe was quick
and very high ; his fkin hot, and moiflened with fvveat ; and the
mufcles of the arms quite relaxed. After thirty-fix hours, there was
little alteration in the fymptoms, only that the eyes were now
open, though fixed, and not affected by the near approach of objects ;
pulfe alfo was lower, and his fkin was neither fo hot, nor fo moifl as
at firft. After forty hours, the ala? nafi were during infpiration drawn
almofl clofe to the feptum ; and, indeed, the trunk of the body
ieemed drawn up at the fame time : the right fide of the face was now
frequently diftorted ; the right arm fometimes convulfed : the heat of
the body diminished ; the pulfe was no longer to be felt, and, m
forty-five hours, he expired.
The membranes, fubflance, and ventricles of the brain, cere-
bellum, and medulla oblongata, were all carefully examined, but
nothing preternatural was obferved. Upon inverting the trunk of the
body, about an ounce, or more, of a bloody fluid, ran out from the
L fpinal
( 74 )
/pinal canal. The fpinal marrow, owing to fome neglect, was not
examined. The vifcera of the thorax, and of the abdomen, appeared
perfectly found. The ftomach contained a yellow fluid.
§ 5. Deep red Blotches, and partial Suppuration in federal
Mufcles of the Body, in Confluence of a Wound.
A man, aged forty-five, fell from a height of about eight feet,
and ftruck his left leg againft the point of a pick-ax. He walked
a good deal after the accident, and the wound, for feveral days, was
quite neglected. On the eighth day, he firit felt pain in his throat,
and, in the evening, fwallowed with difficulty. On tJie eleventh
day, the lower jaw was fixed fo clofe to the upper, as to prevent him
taking folid food. On the thirteenth day, when he was brought
to the hofpital, he could endure no poflure but that of lying prone,
refting upon his knees and elbows, raifed up by pillows. When-
ever he attempted to change that pofture, and very often at
other times, he was violently convulfed, and fometimes thrown out
of bed. In the more moderate fits of convulfion, the courfe of which
could be obferved, he firft flarted fuddenly from the prone pofture to
his knees j the bedy was then drawn forward, the head backward,
and the lips flrongly preffed together ; though he was, at all times,
careful to infert the points of his fingers between them, over which,
in breathing, the air ruihed with a hifling noife. During thefe fits,
which continued fome minutes, the recti abdominis, flerno-maftoidei,
and other mufcles on the fore part of the neck ; thofe within the
arch of the lower jaw, and the mafTeters, were hard to the touch.
He told us, that the fit began with a catching below the navel, that
he had, at all times, exquifile pain in that part, and alfo in the fore
part
< 75 )
part of the neck, and near the jaw, and that he mould be ftifled,
unlefs he kept his lips afunder, by inferting his fingers between them.
The lower jaw was always immoveably fixed fo clofe to the upper,
that the point of the finger could not be puflied between the teeth,
and any interval between them was more owing to the lower jaw
being drawn back than to its being deprerled : the fweat flood in drops
upon his face and his body ; his pulfe was fmall, and between eighty
and ninety : though he had the flrongefl defire to drink, yet the
great difficulty he found in fwallowing, made him moil reluctantly
put the cup to his head, and frequently withdrew it j and, when he
had fucked in a little, he only fwallowed a fmall part of it -y the reft
was fquirted out immediately, and the lips and mufcles of diglutition
were ftrongly convulfed. In the evening of the fourteenth day, his
face was pale, his body covered with cold fweat j his pulfe inter-
mitted i and when his convulfion fits came on, he could not raife his
hand to keep his lips afunder, which was done by an affirmant : the
lower jaw was confiderably relaxed. In the morning of the fifteenth
day, at three o'clock, he fpoke fenfibly : at four he was fuddenly
convulfed ; and, though lying on his belly in bed, was thrown
on his back upon the floor, and died inflantly. Four hours after-
wards, the body being ftill quite warm, the lower jaw was immove-
ably fixed to the upper.
On the outfide of the tendo achillis of the left leg, there was a
wound, which paffing before that tendon, penetrated as far as the
fkin on the oppofite fide behind the internal maleolus. The cavity of
the wound, which contained pus, and two bits of woollen ftocking,
was about the fize of a pigeon's egg. The pofterior tibial nerve, in
paffing along it, was covered by a thin cellular fubftance, which, in
the wound and feveral inches above it, was of a bright red ; but the
nerve cut acrofs appeared found. The mufcles which formed the
L 2 fides
( 7« )
fides of the wound, were partially fuppurated, and, for a confiderablc
way up the leg, of a deep red. The cellular fubftance and tendinous
aponeuroiis on the outfide of the leg were, as high as the knee,
of a deep red; the latter unequally fo, being in fome places almoft
black. In the upper angle of the wound, a nervous filament was loft.
The flefliy part of thefterno-maftoid, fterno-hyoid, firft fcalenus, co-
racohyoid, longus colli, of the right fide, were, in fome places, of a
deep red, as if from blood effufed ; and the longus colli, but no other
correfponding mufcle of the left fide, was affected in a fimilar
manner : the lower extremities of both ftylo-hyoids, and of both hyo-
gloili, were of the deep red colour ; the other mufcles employed in
diglutition, alfo the tongue, palatum, molle, pharynx, part of the
oefophagus, and larynx, upon examination, appeared found. There
were feveral red fpots on the external furface of the tendinous aponeu-
roiis covering the abdomen, and on many parts of both recti
abdominis, there was the fame deep red colour, which penetrated
quite through the fubftance of each mufcle ; the pofterior fur-
face of each being ftill more generally of that colour, and, in many
places, particularly below the navel^ the fibres were confumed,
for about an inch of their length, by ulcers containing a reddifh
matter; the pofterior parts of the (heaths of thofe mufcles, were,
in fome places, oppofite to the ulcerations in the mufcles, of a
light red. The maffeters, the temporals, the mufcles which pull
the head back, and the vifcera of both great cavities, appeared quite
ibund.
CHAP. II.
( 77 )
CHAP. II.
A Defcription of the Symptoms ofDifeafes of the Head, Nerves and
Mufcles, taken from thoje Cafes where the Patients recovered, or
%v here the Author had no Opportunity of examining the Bodies after
Death.
§ i . Lofs of Feeling and of Motion.
THE total lofs of feelingand of motion in different parts of thebody
mofr. frequently happens during a fit of apoplexy, or general in-
feniibility; fometimes it occurs before fuch fit, and fometimes there is
a gradual diminution of feeling with feeblenefs, terminating in complete
numbnefs and lofs of motion, without any fit either preceding or ac-
companying it; the fenfes, memory, and fpeech remaining entire,
or to a certain degree impaired. The parts affected are oft con-
tracted fo that the fingers are bent into the hands, and if at any time
they are extended by force, which cannot always be done, they re-
turn immediately to their former fituation ; the leg, alfo, of the fide
affected is drawn back towards the thigh, and the foot towards the back
of the leg; the paralytic mufcles are at times fuddenly convulled,
which occafions conliderable pain, and they frequently tremble or
fhake, and are generally cold. Sometimes the whole body is affected
by this dilbrder, although the one fide more than the other; fometimes
the lower half of thebody, or only the lower extremities; or the
feet and hands only, but mofl commonly the whole of one fide, the
other remaining unaffected. The ftools, and, at times, the urine,
are retained in the beginning, but towards the end, efpecially in bad
cafes, both of them run off involuntarily. The pulfe is quick and
fmall,
( 78 )
fmall, fometimes having a kind of vibration, or a very feeble heat
is interpofed between two common pulfations, and there are inftances,
even in favourable cafes, where the pulfe cannot be felt. Amend-
ment, or recovery, is commonly preceded by a painful fenfation of
pricking or mooting in the part, after which, in a little time, the
feeling and power of motion return, though in a flight degree ; after-
wards, upon thofe pains going off, the parts recover perfectly their
feeling and power of motion, and laflly their ftrength.
The recovery of the patient is alfo fometimes preceded by an erup-
tion of very painful fpots, raifed a little above the fldn. The fenfe of
feeling and motion commonly return firft in thofe parts which are
nearefr. the brain, proceeding gradually downwards from one member
to another; but I have known recovery take place in a reverfe
order. The difeafe continues from one to three months, though,
commonly, much longer; fometimes it proves fatal in five or fix
months from the firft attack. Sometimes between the paroxyfms the
patient is for a year or two fubject to giddinefs, trembling, &c.
The caufe of this difeafe is often unknown. Sometimes it happens
during a fever, and often fupervenes flight injuries of the head, when,
without any fracture of the fkull, they have been followed by infenfi-
bility, either immediately or a day or two after the accident, and in all
thofe cafes, the fide of the body affected is oppofite to the fide of the
head where the injury has been received.
Do not the pains which commonly precede recovery, point out
the ufe of irritating and painful applications to the part ?
Does not the eruption of painful fpots indicate,in a particular manner,
the utility of blifters ?
§ 2. The
( 79 )
§ 2. Lofs of Motion with Relaxation of the Parts,
All or only fome of the limbs fuddenly lofe the power of motion,
but without any remarkable diminution of feeling; this fometimes
happens without pain ; at other times it is accompanied or preceded
by very violent pain. When unattended with pain the caufe is com-
monly unknown, and, if the feeling is unimpaired, the patient, with-
out any disagreeable fenfation, recovers a little ftrength at firft, and,
finally, the perfect ufe of his limbs.
The cafes attended or preceded by violent pains, moft fre-
quently occur amongft people who are employed in the feveral trades
in which lead or quickfilver are ufed, fuch as glaziers, plumbers,
colour- makers and gilders; there is this difference however, that
thofe perfons who have been expofed to the fumes of quickfrlver, have,
befides the other fymptoms, almofl perpetual tremors of the
limbs.
In thofe cafes attended with pain I have alfo obferved, that the fu-
perior extremities are more frequently affected than the inferior, and
that the mufcles of the hands are remarkably wafted. The dry
belly-ach, formerly defcribed, commonly, and efpecially in painters
who make ufe of turpentine, precedes or accompanies any affections
of the limbs.
The patient, even when he quits his bufinefs, recovers his health
but flowly j firft. acquiring the power of bending, afterwards of ex-
tending the limbs ; but there are few inftances of a complete recovery
till after many months, or even years, and a return of the complaint
is
( 8o )
is the almofl certain confequence of returning to their former man-
ner of life. The moil; effectual prefervatives are keeping clean,
and avoiding, as much as poflible, all immediate contact with the
metal, its calx or fumes.
§ 3. Lofs of Motion with Contraction of the Parts.*
A woman, aged thirty-one, fell down fuddenly whilft walking.
She retained her fenfes, but had violent pains and contractions in the
mufcles of both arms, which were fo ftrongly bent that all efforts to
extend them were ineffectual, and the attempting it only caufed more
exquifite pain ; but though the upper extremities were fo greatly, the
lower were little affected, and flie only complained of a flight pain
in one ancle. After ten hours there was no change in her iituation ;
after twenty the pains had fomewhat abated, and fhe could move her
arms a little. After thirty hours the pains had entirely ceafed, and
fhe could move all her joints eafily. In a few days more me recovered
the f trength of her arms, and in a week, except that fhe was fome-
what low-fpirited, had no farther complaint.
A woman, aged twenty-feven, was for feveral years fubject,
commonly in cold weather, to fits of coldnefs and of pain in the ex-
ternal parts of the head, face and neck, and in the mufcles within
the arch of the lower jaw ; during thefe fits fhe could not bear the
flightefl preffure on the parts affected, and the lower jaw was im-
moveably fixed, at firfl, almoft clofe to the upper one, but after-
wards, as the pains diminifhed, it relaxed fo far as to admit the point
of
* Under this head I have given three cafes, the examples not being fufficiently
numerous to enable me to draw up any general hiflory of the complaint.
( Si )
of the finger between the teeth. In about a month or fix weeks the
pains ceafed, and fhe perfectly recovered the ufe of the jaw.
A woman, aged twenty-one, whofe hiftory I have in part for-
merly related*, three weeks after receiving the blow on her chert,
was feifed with a fit, which returned fometimes every day, though
more commonly after an interval of a week, a fortnight, or even a
month. When fhe perceived the approach of the fit, which was pre-
ceded by partial mufcular contractions, what me called twitchings or
catchings, fhe laid herfelf on her back in bed, her limbs were im-
mediately ftretched out, her fingers and toes ftrongly drawn in, and
her head fo much drawn backwards that her face was turned directly to
the head of the bed ; in this ftate fhe remained ftruggling for a confi-
derable time, her body bent upwards, whilff. the crown of her head
was forcibly prefTed againft the bed, her neck and breafl were alfo
fwelled, and her belly was repeatedly raifed forwards ; at this time
the mufcles every where felt rigid ; fometimes the bead, from the
pofture above defcribed, was drawn flowly forwards alfo, from fide
to fide. The eyes were fixed, and not affected by the neareft approach
of objects. She frothed at the mouth and frequently bit her tongue,
(which was pufhed out) from the convulfive contractions of the muf-
cles of the lower jaw. Sometimes fhe would fing, or make a noife
like the barking of a dog, at other times fhe uttered the mo/f. dole-
ful cries, after which the mufcles were always foft, the limbs re-'
laxed, and her hands opened ; in this fituation fhe ufed to remain
from one to eight hours, and after each fit complained of exceflive
wearinefs and pains all over her body. Sometimes her fits were much
flighter, fome of her limbs only being contracted -, and, though fhe
loll her fight, retaining her other fenfes. During the intervals of the
M fits,
* Vide page 45.
( 32 )
fits, me was troubled with twitchings and tremblings, either of her
whole body, of one fide, or of a particular limb only, and thefe
were always greatly increafed from any fright or flurry. She frequently
gnafhed her teeth, and fometimes with fo much violence when me
was drinking, as to break the cup. She alfo complained of head-
ach, giddinefs, dimnefs of fight, lownefs of fpirits, coldnefs of her
lower extremities, and, fometimes, had coldfweats ; her pulfe was be-
tween eighty and ninety. Her fits remained violent near fourteen
months, but became more moderate after the burfting forth of mat-
ter from her fide, and did not afterwards affecl: her fenfes, and in four
months after this event took place, they, as well as the concomi-
tant fymptoms, difappeared entirely, and have not fince, now near
four years, in any degree returned.
§ 4. Perpetual involwitary Motion.
Mbit commonly after a fright, fometimes after convulfions, h/f-
terical or fainting fits, and fometimes nothing remarkable having pre-
ceded, the patients are feized with a perpetual involuntary motion,
but without pain, either of all the limbs and fpine, or of both arms,
though unequally, or of the arm and leg of one fide, or of one arm
only, or of the belly and breaft, which laft motion is much quicker
than that of refpiration. Thefe motions are fometimes fo violent that,
when general, the patients cannot lie in bed, and when one arm
only is affected, its motion will throw them down, if while walking
they happen to be off their guard ; by the perpetual rubbing the cuti-
cle is fometimes abraded from the infides of the fingers. Thefe mo-
tions fometimes encrcafe in violence in the evening, and on al-
ternate days, and, when going off intermit in the forenoon. The
patients
( H )
patients fometimes laugh or cry, are troubled with a hiccough, or imack
with the tongue and lips ; the tongue is often pufhed out very far,
and the lower jaw is in perpetual motion; if they happen, as is fome-
times the cafe, to flumber for a little, the parts, during fleep, are at
reft. Sometimes they complain of pain in the throat, breaft and neck.
The fpeech is commonly affected, but the fenfes are entire. Both
ftools and urine are retained longer than is natural. The pulfe is
fmall and fometimes quick. By a fuperior external force the motion of
a limb may be flopt for a little, commonly without any inconvenience
to the patient ; but in one cafe, when the arm was held, the patient
funk quietly into a fit, as if (he had been afleep, the other limbs
retaining the pofture they happened to be in when the fit began, and
when, on letting go the arm, the motions of it returned, the feeling
and the power of motion in the other limbs returned alfo ; fometimes
the motions of the arms, of their own accord, alternately ceafed and
returned, and the fame confequences followed. The pulfe did not
vary in the different ftates. In the fame patient the left arm was,
without any inconvenience, always at reft when fhe lay down, and
always in motion when (he fat upright or ftood, the right arm was
not affected by change of pofture, till her recovery was advanced,
and then it was influenced by it in the fame manner as the left arm.
had formerly been.
The fubjects of this diforder are women and children. The dura-
tion is commonly not longer than one or two months ; but fometimes
the motions of particular limbs continue for feveral years^ and in one
cafe, where they had been violent, the limb inflamed. Patients are
apt to fuffer a relapfe, efpecially when the difeafe originated in a
fright.
M 2 Does
f 84 )
Does the relief which i& afforded during fleep, direct us to the uft-
of opiates ?
C HA P. HL
Obfervations on the Effects of Remedies in Difeafes of the Head,8tc
THE fenfe of feeling and thepower of motion were commonly
encreafed after the application of blifters to the nape of the
neck, or to the arms, when thefe were the parts affected, and to the
os facrum, when the lower limbs were affected. Liniment, fapon:
rubbed on the parts appeared to have a fimilar effect— After re-
ceiving once in three or four days about a dozen of flight mocks
of electricity, the fenfe of feeling was in a few hours, and the power
of motion in a few days encreafed — After going into a warm bath the
pulfe rofe, and the ftrength of the limbs was encreafed a little;
Painters ■, whofe wrifts were weak, found fome benefit after having
repeatedly held their hands and the lower parts of their arms in the
warm moift grains of malt. After hot medicines, fuch as fal. C. C.
vol. muftard-feed, horfe-raddifh-root, gum gauiacum, faffron, and
fome other fudorifics, a glowing was felt in the affected parts, and
was followed by fweating, and, in fome cafes, when bliflers alfo had
been applied, the fenfe of feeling and power of motion were perfectly
reftored. After Peruvian bark and fteel medicines, tremors and
weaknefs of the limbs were diminiflied. In regard to the perpetual
involuntary motions, the moft remarkable relief, or rather almofl per-
fect recovery, happened to a woman, who, having a fecond time had
this
( »5 )
this diforder conftantly in her arms for three years, took mufk a
little longer than a fortnight, to the quantity firfl of one drachm,
and afterwards to that of one drachm and an half each day ; me
fweated a little during the courfe, and was giddy from the encreafed
dofe. Opiates and fetid gums, with fait of hartfhorn, feemed alfo
to have in thefe cafes very good effects..
As the difeafes hitherto defcribed are principally fuch as arife from
tjie affections of particular organs, I have been fuller in giving ana-
tomical defcriptions than may perhaps be necefTary hereafter. And
therefore at the doling of this part of my undertaking, I reckon it
incumbent upon me to fay fomething of the advantages, which, may-
be derived from the dilTectionof morbid bodies..
And here it firfl occurs, that it mufl furely give a Phyiician
great fatisfaction and pleafure to find, by the appearances, that he
has understood a. diforder and treated it properly ; but this being, a
kind of delicate luxury in fcience, relifhed only by the moil liberal
minds, and therefore a fuperfluity, we mufl next enquire, whether
this modern method of arriving at knowledge, may not be attended
with fome more folid advantages, advantages really conducive to the
health and happinefs of mankind.
Though there are many difeafes which have not hitherto been in
any degree illuftrated by diffe&ions, yet the great light which has
been thrown upon others, by the accidental directions of ana-
tomifts, ignorant for the mod part of the complaints which
preceded death, or who learned them only by hearfay, and after
the diffections had been performed, is a Sufficient earnefl of the
great encreafe in the knowledge of difeafes which might be made,
were Phyficians, who have known the complaints, to examine more
minutely
{ U )
minutely and attentively than they commonly do, the bodies of the
dead. A perfon who has carefully performed, or even attended to
the difleclion of one cafe, will afterward:- <ook upon fimilar cafes
with a more piercing eye than before j •••• iymptoms fuggeft to
the mind the ideas of certain changes in trie body, fo, on the other
hand, the obfervation of certain change . i\\ the body fuggefts the
ideas of certain fymptoms connected with them, which, though ne-
ceflary to a full knowledge of the difeaL., would otherwife efcape the
notice of the Phyfician.
Directions have alfo led to feveral ufeful and neceflary methods of
treating difeafes, which were formerly unknown, and have, likewife,
iliewn the inutility and impropriety of many common methods of
practice. They tend more than any thing whatever to fhew the
infignificancy and the futility of many highly and long applauded
remedies, and thus the mind being fet at liberty from a flaviih
implicit faith in their efficacy, its powers may be directed to more
worthy objects.
If, therefore, by directions, in the performing of which, dif-
eafes were frequently only a fecondary object, fo great a progrefs
has been made in the knowledge, and in the treatment of them,
let thofe who wifh to promote the great intereft of mankind,
avoid joining themfelves to the lazy tribe of defpondents, who
affert that Phyfick cannot be improved, and who, on that pre-
tence, give way to their innate love of indolence and floth. Let the
generous few rather hope, nay, let them be affured, that by their
united and continued efforts, the knowledge of difeafes may be
very highly and effentially promoted.
E X P E R I-
MM*
EXPERIMENTS
0 N
VARIOUS SUBJECTS.
EXPERIMENTS,
DIETETIC A L and STATICAL.
EXPERIMENTS
O N
DIET.
INTRODUCTION.
ALTHOUGH air is more immediately neceffary to life than
food, the knowledge of the latter feems of more importance ; it
admits certainly of greater variety, and a choice is more frequently in
our power. A very fpare and fimple diet has commonly been
recommended as mod conducive to health, but it would be more
beneficial to mankind if we could mew them that a pleafant and va-
ried diet was equally confident with health as the very Ariel: regimen
of Cornaro, or the Miller of EfTex. Thefe and other abftemious people,
who, having experienced the greateft, extremities of bad health, were
driven to temperance as their laft refource, may run out in praifes
of a fimple diet, but the probability is, that nothing but the dread
of former fufferings, could have given them refolution to perfevere
in-fo fcricl: a courfe of abflinence; which, perfons who are in
N health,
( 9o )
health, and have no fuch apprehenfion, could not be induced to un-
dertake, or, if they did, would not long continue.
In all cafes great allowance murr. be made for the weaknefs of hu-
man nature ; the delires and appetites of mankind muft, to a certain
degree, be gratified, and the man, that wifhes to be moil ufeful,
will imitate the indulgent parent who, whilft he endeavours to pro-
mote the true interefts of his children, allows them the full enjoyment
of all thofe innocent pleafures which they take delight in. If pof-
iibly it could be pointed out to mankind that fome articles ufed as
food were hurtful, whilft others were in their nature innocent, and
that the latter were numerous, various and pleafant, they might, per-
haps, from a regard to their health, be induced to forego thofe which
were hurtful, and confine themfelves to thofe which were innocent. To
eftablifh fuch a distinction as this, from experiment and obfervation,
is the chief objecT: of my enquiry : and I confefs it will afford me a
fingular pleafure if I can prove, by experiment, that a pleafant and va-
ried diet is equally conducive to health, with a more ftridr. and
fimple one ; at the fame time I fhall endeavour to keep my mind un-
biased in my fearch after truth, and, if a fimple diet feems the moil
healthy, I fhall not hefitate to declare it.
But before entering upon the prefent, or any other inveftigation,
it may not be improper to attend to a difKnclion, made by my
Lord Bacon, between ufeful and curious knowledge ; the latter,
indeed, or Experimenta lucifera, he recommends, as nearly of equal
importance with the former, or Experimenta fructifera, though to
me they appear widely different. The only teft of the utility of
knowledge is, its promoting the happinefs of mankind ; which,
though
( 9i )
though the Experimenta lucifera may do at fome future period, the
Experimenta fructifera, as having directly and immediately this
effect, are furely to be preferred ; and, therefore, though I
admit that all knowledge is delireable, from the pleafure it af-
fords, yet, confidering the fhortnefs of human life, and the very
narrow limits of human abilities, and confidering alfo that there are
many things Hill unknown which might be of advantage to fociety,
it may be doubted whether every perfon be not in ftrict duty bound to
direct his whole attention to the cultivation of ufeful knowledge.
In the courfe of the prefent enquiry, I have fometimes doubted
whether an accurate attention to the difcharges of the body be not
more a matter of cunolity than of ufe ; and, if our attention mould
not be chiefly directed to obferve the different effects of food on the
body ; whether, for inftance, it agrees or difagrees with the flo-
mach, is more or lefs nourishing, has the quality of invigorating, or of
occalioning lazinefs and inactivity, if it enlivens or deadens the fa-
culties, and if J.t creates or allays the feveral appetites and de-
fires.
If after what I have faid, I mall be thought to have indulged my-
felf with attending too accurately to the difcharges of the body, it
muft be partly imputed to my defire to avoid the appearance of enter-
taining a doubt, that what fome of the firft names in Phyfic have
thought deferving their attention were things of little moment.
N 2 Dr.
( 92 )
Dr. Stark, before he began his Experiments on Diet, had col-
lected fome faffs on the fubjeff, and had made fome obfervations
relative to digejlion, which I have introduced in this place, ima-
gining that they would not be unacceptable to the public.
Faffs relative to Diet.
Dr. B. Franklin, of Philadelphia, informed me, that he himfelf,
when a journeyman Printer, lived a fortnight on bread and water,
at the rate of iolfr of bread per week, and that he found himfelf flout
and hearty with this diet.
He likewife told me, that he knew a Gentleman, who, having
been taken by the Barbary Corfairs, was employed to work in the
quarries, and that the only food allowed him was barley, a certain
quantity of which was put into his pockets every morning; water he
found at the place of labour ; his practice was, to eat a little now
and then, whilfr. at work, and, having remained many years in fla-
very, he had acquired fo far the habit of eating frequently and little
at a time, that when he returned home his only food was ginger-
bread-nuts, which he carried in his pocket, and of which he eat
from time to time.
By Sir John Pringle I was told, that the inhabitants of Zephalo-
nia, during fome parts of the year, live wholly on currants. He
alfo
( 93 )
i
alfo faid, that he knew a Lady, now ninety years of age, who eat
only the pure fat of meat.
I learned from Dr. Mackenzie, that many of the poor people near
Invernefs, never took any kind of animal food, not even eggs,
cheefe, butter or milk.
Mr. Hewfon informed me, that Mr. Orred, a Surgeon at Chefter,
knew a fhip's crew, who being detained at Sea after all their provi-
fions were confumed, lived, one part of them on tobacco, the other
on fugar : and that the latter generally died of the fcurvy, whilfl
the former remained free from this difeafe, or foon recovered.
Dr. Cirelli fays, that the Neapolitan Phyficians frequently
allow their patients, in fevers, nothing but water for forty days
together.
Mr. Slingfby has lived many years on bread, milk and vegetables,
without animal food or wine : he has excellent fpirits, is very vi-
gorous, and has been free from the gout ever fince he began this re-
gimen.
Dr. Knight has lived alfo many years on a diet flric~tly vegetable,
excepting eggs in puddings, milk with his tea and chocolate, and
butter — He finds wine necerlary to him — Since he lived in this
manner he has been free from the gout.
Obferuations
( 9 + )
Obfervatwis on Dig'flion.
A woman, who was in the practice of dram- drinking, after taking
an emetic, vomited many pieces of fat, fome pieces of griftle, and
only one very fmall bit of the lean of veal, which me had eat twenty-
four hours before. She brought up, likewife, a bit of apple, and
fome pieces of the fkins of roafled apples which me had eat twenty
hours before. Alio part of a brown cruit of bread which me had eat
about three hours before.
A young man, ill of a fever, having taken an emetic, vomited
fome fat broth, with bits of bread, which he had eat three hours
before.
A young man, who had been flightly indifpofed about a week,
after taking an emetic, brought up fome mutton, which he had
eat three hours before, and nearly in the fame (late in which he eat it.
A girl, in a fever, vomited fpontaneoufly, and brought off her
flomach fome fifli, which me had eat three hours before.
A man, with purging, head-ach, &c. brought off his flomach,
by an emetic, fome very difagreeable bitter fluff, but without any
appearance of bread and butter, of which he had eaten very heartily
about fevcn hours before.
A girl, fubject to fits, after taking an emetic, vomited fome
oyflers, which me had eat three hours before, but there was no
appearance of veal, which (lie had eat twenty-feven hours before.
A girl,
( 95 )
A girl, fubjedl: to pains in her ftomach, after taking an eme-
tic, vomited many pieces of the fkin, but fcarcely any of the
lean of roafted veal, which me had eaten fix hours before.
A woman, with a tertian fever, head-ach, &c. after taking an
emetic, brought up fome mutton, very little altered. She had not
eat it long before.
Mrs. I — m informed me, that her fon, a little boy, and her daugh-
ter, a delicate girl, vomited, one morning, fome beef, which they
had eat at dinner, between three and four o'clock the preceding day.
ABSTRACT
( 96 )
ABSTRACT of a JOURNAL kept during a Courft '
of Experiments on Diet.
N. B. The weight of the folic? food and ftools, is marked in Troy weight, that of the
body in Avoirdupois ; the quantity of liquids was determined by wine
meafurs — The weight of my body, dreffcd in my ufual clothes, at the begin-
ning of thefe Experiments was, 12ft. 31b. or 1 7 1 lb . Avoirdupois.
EXPERIMENT
I.
Diet of Bread and Water.
t2 i
.5 . State of the at-
Daily allowance
Daily lofs of
Number and to-
Weight of my
2 \o1 mofphere during
v £" the period.
of food
weight.
tal weight of
(tools.
body at the end
of the period.
Ik
Bread 20 oz.
5 oz. 5 dr.
5 ftools, weigh-
11 ft. i2lb.8oz.
0
Water 4 lb.
ing 7 oz. 5 dr.
#1 w
It
1 B
■»
V
£
Thermometer Bread, 30 oz. 6 oz. 10 dr.
7 ftools, weigh-
nft. 1 0 lb. 8 oz.
D 3
•5 ' — '
from 60 to 70.
Water, 2 lb.
ing iooz. 5 dr.
8"S
Weather com-
monly ferene,
W* r^j
fometimes
13 «J
O -C
cloudy, feldom
u 0
Ph **
13 C
§&
u O
rain.
Third
( 97 )
State of the at-
Daily allowance
Daily lofs of
Number and to-
Weight of my
V >^
mofphere during
of food.
weight.
tal weight of
body at the end
*— >
the period.
ftools.
of the period.
bZ:
o o
Thermometer
Bread, 30 02.
6 oz. 10 dr.
1 {tool, weigh-
lift. 7 lb. 8 oz.
T3 ^
from 6010-73.
Water, 2 lb.
ing 20Z. 5 dr.
O ~
Often ferene,
4J "^
fometimes
1
cloudy.
15
.c
OS
Daily gain in
i^
weight.
iv
Thermometer
Bread, 38 oz.
3 oz. 6 dr.
3 ftools, weigh-
11 ft. 9 oz. 8 dr.
■e^
from 63 to 66.
Watery lb. 8 oz.
ing 2 lb. 1 oz.
o N
Commonly
3 dr.
&!
cloudy, fome-
■e °
times rain, fome-
3
times ferene.
O
R E M A R K S.
To determine how long the food is ufually retained in the
body, I repeatedly fwallowed muftard or carraway-feeds and ob-
ferved, that when coflive, .they did not pais with the firfl, but with
the fecond and third ftool ; and, commonly, after thirty-fix or forty-
eight hours i when open in the body, they came away with the firft
ftool, the next morning.
Before I began regularly this Courfe of Experiments, I had, for
feveral weeks been, now and then, making trial of it ; fometimes,
inflead of water, I took, in the morning, a weak infufion of tea,.
O iaffafras,
( 9S )
affafras, or of fome herb, but without milk or fugar. My ftools
were of a fmooth confiflence and flimy furface, like clay.
Although upon the allowance of twenty ounces of bread, I was
hearty, in good fpirits, and had fome defires, yet I found it ne-
cefTary to encreafe it, not only as I fell away, but becaufe I was often
very hungry.
On the allowance of thirty ounces, I fometimes, immediately
after eating, had a little wind upwards, and fometimes, though rarely,
a little downwards. My ftools were gradually fofter. I ftill
fell away very vifibly; had hardly any defires, though hearty in
other refpects. Sometimes I felt a flight fickiihnefs and want of
appetite, which went off after eating a bit of brer.d.
Imagining that the ficknefs might be owing to my taking an over
proportion of liquid, I endeavoured, during the third period, to af-
certain how much liquid was abfolutely necefTary to the quantity of
bread I eat, and found, that though I could eafily eat my common
meal often ounces, without any liquid, and was not at all thirrty,
even for fome time after, yet in two or three hours, an intolerable
third came on, which could not be allayed by lefs than ten
ounces of liquid.
I likewife found that when I drank lefs than two pints a day
I was thirlty in the evening, and had a flight pain in -my fto-
mach. formerly I ufed to make eleven or twelve ounces of
urine at a time, but now five or fix ounces brought on the incli-
nation, and my water was high coloured During the third period
I was one day irregular, having ate about four ounces of meat, and
drank two or three glaiTes of wine. At the conclufion of it,
I was
( 99 )
I was perfectly hearty, my head clear, often hungry, but never had
any deiires.
When I eat thirty-eight ounces of bread (the allowance during
the fourth period) at five or fix times, my appetite was not more
than fatisfied, but if I made fewer meals I found my appetite
fatiated.
I fometimes varied my daily quantity of bread, by taking from
the allowance of one day and adding to that of the day fol-
lowing, but I found that the moft I could eat in one day was
forty-fix ounces, and that the greater! quantity I could eat at one
time, without uneafinefs, was twenty ounces ; that the fenfation of
hunger began four hours after eating this quantity, when I could
eat twenty ounces more. I once forced myfelf, to eat, at one
meal, in an hour and ten minutes, thirty ounces of bread, I brought
up fome wind off my ftomach whilft I was eating it, had
afterwards much noife in my bowels, and in a few hours a bolar
(tool, weighing one pound ; I continued uneafy during the whole
of the evening, but was quite well and hungry next morning.
During this laft period I fometimes had deiires (Venus bis) but
never before, fince I began this Courfe of Experiments.
By Experiment, I determined, the quantity of faliva fecreted
in half an hour, to be whilft the parts were at reft, four drachms,
whilft eating, five ounces four drachms.
O 2 EXPERIMENT
choolO.!J>
( 100 )
EXPERIMENT II.
»
D/ttf of Bread and Water with Sugar.
o
State of the at-
mofphere during
the period.
Daily allowance
of food
Daily gain of
weight.
Number and to-
tal weight of
ftools.
Weight of my
body at the end
of the period.
Firft period, from t
July, to the 3do
Thermometer
from 62 to 66.
Weather com-
monly cloudy.
Bread 34 02.
Sugar 4 oz.
Water 3^ lb.
2 oz.
Purging.
11 ft. iolb. 8oz.
13
£ 3
s<
Thermometer
from 64 to 74.
Weather com-
monly ferene.
Bread, 30 oz.
Sugar 8 oz.
Water, 3^ lb.
Weight of the
body ftationary.
2 ftools, weigh-
ing iooz. 4 dr.
11 ft. 10 lb. 8oz.
1 « °
u
u
t/5
-
o
"S w:
-. 3"
Daily lofs of
weight
5<
, - ■ -**
Thermometer
' from 63 to 66.
We.ither ferene,
fometimesrain.
Diet irregular.
lib.
Purging.
lift. 61b.
"3 "w
3
1
Fourth
( ioi )
2~~
*•
State of the at-
Daily allowance
Daily gain of
Number and to-
Weight of my
mofphere during
of food.
weight.
tal weight of
body at the end
the period.
ftools.
of the period.
i<
Thermometer
Bread 26 oz.
Nearly 3 oz,
Purging.
lift. 7lb.
T3 '*-'
from 6 1 to 63.
Water 2 lb. 5 oz.
o o\
Serene weather,
Pi.r
fometimes rain.
-C ~
" o
3 ~
O
5*
Thermometer
Diet irregular.
Weight of the
1 loofe ftool.
lift. 71b.
from 59 to 61.
body ftationary.
-5 5°
Weather ferene,
fometimes rain.
.2 ?
.
£2
I
£
REMARKS.
Sugar feemed to increafe the flow of faliva into the mouth,
for with fugar I could eat more bread at a time, than I could
pofiibly do without this addition.
In the afternoon of the firft day after ufing fugar I palled a good
deal of fetid wind downwards, and early next morning had a liquid
ftool. I had afterwards three loofe ftools, weighing one pound five
ounces ; weak defires, (Venus femel) during the firft period.
After I began to ufe fugar with my bread, I found that a
finaller quantity of liquid prevented thirft than when I eat bread
alone.
( J°2 )
alone. With my prefent diet, of thirty ounces of bread, and
eight ounces of fugar, two pints of liquid a day are fufficient
to allay my thirft ; whereas, when I ate thirty-eight ounces of bread,
without fugar, I found that three pints and a half of liquid were
abfolutely neceffary.
I commonly ate eight ounces of fugar at a meal, without any in-
convenience, and became hungry three hours after it • my appetite
was not at all cloyed with the fugar. I palled hardly any wind
either way, and never had any delires.
On the ioth I ate, at three different times, before one o'clock,
twenty ounces of fugar, and, though I ate the laft of it with re-
luctance, and was fickifh after it, yet it did not fatisfy my appetite.
At two o'clock I became very hungry, and at three began to eat bread
with great pleafure, and ate twenty ounces of it, drinking two
pints and a half of water, which I found fuflicient to allay my
thirft.
On the i ith I ate twenty-four ounces of bread, and fixteen ounces
of fugar, but the laft part of it with great abhorrence. I now per-
ceived fmall ulcers on the infide of my cheeks, particularly near
a bad tooth, in the lower jaw, of the right fide ; the gums of the
upper jaw, of the fame fide, were fwelled and red, and bled when
preiTed with the finger, the right noftril was alfo internally red or
purple, and very painful. I had one thin flooL
On the 1 2th I ate thirty ounces of bread, with ten of fugar, had
little appetite for fupper, and after it a thin flool.
The
( io3 )
On the 13th, having been extremely ill, during the night, with
pains in my bowels and fvveating ; at day-break, I had a large
thin ftocl, and two liquid ftools afterwards, but paffed no wind,
nor was troubled with any in my bowels. I had no appetite for
breakfaft, could not tafte fugar, dined on a few ounces of meat,
with about twelve ounces of bread, and drank two or three glades
of wine.
On the 14th I perceived feveral fmall purple flreaks on my
right moulder, but the fores in the infide of my mouth, and my
gums were better, and my noftril lefs painful.
On the 15th the affection of my gums, though lefs in degree, had
become more general, having fpread to the left fide, their femilunar
edges were of a deep red, and feveral drops of blood iffued from
my right noftril.
N.B. Until the 18th I had, every day, t'hree or four liquid
ftools, containing fome clear gelatinous fubftance, and felt but little
pain or wind in my bowels — on the 18th and 19th I had one ftool
each day.
On the 1 8th, fome part of the gums of both jaws, and on both
fides, were red and fwelled, but none of them of that purple co-
lour, nor fo apt to bleed as fome days ago, the fores in my
mouth were healing, and the ftreaks on my moulder alrnofl: gone.
I never had the fmallefl defires.
From the 19th to the 24th, my food wa* thirty ounces of bread
with three pints of water every day, excepting on the 2 2d, when
I dined
( 104 )
I dined heartily on meat and fruit, and drank fome wine. Venus
femel.
N.B. On the 21ft I made an experiment with two drachms of
•faeces, of a pilular confidence, which I had voided, after having lived
about a week on bread and water ; they were warned four or five
times in about fix ounces of water, which was thereby rendered
milky ; but after ftanding ten or twelve days, and depofiting a fe-
diment, it became again almoft tranfparent ; the refiduum, faved
on the filtring paper, weighed one fcruple and half a grain, was
of a darkifh green colour, and perfectly inodorous— Bread, treated
in a fimilar manner, occafioned no milkinefs, and the water, inftead
•f becoming putrid, was converted into a weak vinous liquor
EXPERIMENT
( io5 )
EXPERIMENT III.
Diet of Bread and Water with Oil of Olives.
-*■
State of the at-
Daily allowance
Daily gain or
Number and to-
Weight of my
mofphere during
of food
lofs of weight.
tal weight of
body at the end
-5 m
the period.
ftools.
of the period.
o <*•
Thermometer
Bread 30 oz.
Gained nearly
2 ftools, weighing
1 1 ft. 9 lb.
^4-«
from 59 to 62.
Oilof01ives24oz
5 oz. 3 dr.
1 lb. 4 oz. 6 dr.
Weather ferene,
Water 3 lb.
fometimes rainy.
• is *^
O u
° u
Thermometer
Bread, 30 oz.
Loft nearly 9 oz.
1 ftool, weigh-
11 ft. 5 lb. 8 oz.
from 63 or 64.
Water, 3 lb.
3 dr.
ing 40Z. 4 dr.
Weather ferene
°£2
or cloudy.
«^3
15
u 4-.
Oh O
"1
3 M
U 3
OT <
O
Thermometer
Diet irregular.
0
Purging.
11ft. 131b. 8oz.
from 57 to 661
Weather com-
monly rainy.
2 'S
'5 •?
o-.~
'
H .
REMARK^
( io6 )
REMARKS.
Two ounces of oil, taken at one meal, was fo large a quantity as
to be difagreeable ; three ounces in the day occafioned fome uneafinefs
in my bowels ; and four ounces griped me very much — I had now
and then fome wind upwards, and fometimes, after being a little
griped, paffed fome downwards ; my appetite was fufficiently fatis-
fied -, I was iometimes a little tliirfly, and frequently had denies in
the night.
On the 23d of Auguft, a large double tooth, which had been very
troublefome to me, during the time, and even after the fugar diet, was
extracted from the lower jaw ; the day following I had great pain in
the part from whence the tooth was taken, and the gum appeared
fomewhat black.*
The fecond night I had no fleep from the exceflive pain, and an
abominably putrid flough was formed. The gums in the neighbour-
hood of the fore fwelled more than ever'and became in part livid, with
a fetid white fluff round their edges, whilft the gums immediately
over the fore were black and infenfible. My appetite was keen, not-
withflanding this complaint in my mouth, and was not fatisfied
until the 5 th of September, when I loft it entirely, and became
dull, I never had any wind in my ftomach, and feldom in my bowels.
J^o defires. I commonly kept fome powder of bark on the fore, and
warned it frequently with diluted vinegar.
On
( i<>7 )
On the 5 th of September the Hough was fmoother, not. fo fetid or
difigreeable, but the affection of the gums was more general, and
fome of them a little eroded,
On the 6th I had a loofe ftool in the morning, little or no ap-
petite.
On the 7th, ftill no appetite, I had five loofe ftools, with griping
and wind, and the ftools partly confided of a kind of gelatinous
matter. On going to bed in the evening I was feized with coldnefs
and fhivering, had fourteen watery ftools in the night, with great
pain and wind in my bowels, &c.
On the 8th I was fo weak and low that I almofr. fainted m walking
acrofs my room ; had four or live loofe ftools in the courfe of the day,
was fick, and my tongue foul. Having taken fifteen grains of ipeca-
cuanha, I vomited, firft a clear liquor, of the colour of Burgundy,
afterwards a brown and extremely bitter liquor. In the evening I
obferved that the flough on the fore, and fome parts of the gums
had become black, whilft the gums of the upper jaw, oppoiite the
fore, were fwelled, fo as almofl to reach the extremity of the eye-
tooth ; and I fpat, in confiderable quantity, a very difagreeable, fetid,
yellowim fluid. I took half an ounce of the extract of the bark,
and had three ftools, but they were not fo thin as before.
On the 9th, although I was much better, my pulfe was ftill
very low, and I was apt to faint whenever I got out of bed;
fome black floughs were feparated from the gums, which now put
on a more favourable appearance. The eminences or papillae, which
to me are natural on the inlide of my legs and thighs, were red or
P 2 purple,
( io8 )
purple, and the difcolouration of the fkin fpread beyond the emi-
nencies -, there were alfo a few light brown fpots on feveral parts of
my lower extremities. I took an ounce and an half of the extract of
bark, with fome mulled Port wine, which had no very fenfible
effect -y but I found myfelf greatly revived by a bafon of mutton
broth, which was almoft the firfl food I had taken fince the 5th ;
I had two foft ftools. I continued to take the bark for a few days
longer, and lived freely on animal food, milk and wine, until the
1 8th 5 when I felt myfelf quite recovered,
EXPERIMENT
( "9 )
EXPERIMENT IV.
Diet of Bread and Water, with Milk.
i o
f"5 •
■5 ■"
a 0.
g QJ
O CO
"O -a
O N
'H N
State of the at-
mofphere during
the period.
Thermometer
from 57 to 62.
Weather ferene,
Daily allowance
of food.
Bread, 30 oz.
Water, 3 lb.
Milk, 4 lb.
Daily gain of
weight.
2 oz.
Number and to-
tal weight of
ftools.
4 ftools, weigh-
ing 3 lb. 10 oz.
Weight of my
body at the end
of the period.
12ft.
-a
N •
•5 s
si
-a c
O j-
u *S
Oh n
5 *-'
3 0
u
-O
Thermometer
from 55 to 57.
Weather cloudy
or ferene.
Bread, 30 oz.
Water, 3 lb.
Milk, 4 lb.
2 oz.
2 ftools, weigh-
ing 1 lb. 4 dr.
12 ft. 8 oz.
1
n a;
jl
2co
1 0
-c -
0 •&
C 0\
U N
-a j=
>-i *->
12 0
P ~
Thermometer
from 5 5 to 59.
Weather rainy,
or ferene.
Bread 30 oz.
Water 3 lb.
Daily lofs of
weight.
10 oz, j dr.
2 ftools, weigh-
5 oz. 4 dr.
1 ift. 12 lb. 8 cz.
u 0
p N
' ermometer
$4. or 5?.
Weather ferene,
I] , or rain.
Diet irregular.
12 ft.
( no )
REMARKS.
By the 18 th of September the fore in that part of the gums
from which the bad tooth had been extracted, was perfectly
healed ; and the gums, though ftill a little fwelled, were daily getting
better. My flools were commonly foft, and of a buff colour ; I
was fometimes a good deal griped, (Venus bis.)
From the 22d to the 26th my ftools were very hard, forced
off with great difficulty and pain, and were covered with blood ;
I was quite flout and hearty, and had, fometimes, defires.
On the 29th although the gums were not to appearance worfe,
yet I frequently fucked blood from them, and my finger, after
touching them, had an offenfive fmell ; what I fpit was yellow-
ifh and fetid. I had obferved none of thefe fymptoms before,
iince my fevere illnefs.
From the 29th of September to the 2d of October, I lived
rather highly, on animal food, and, from being coftive, I became
loofe in my body. The bleeding of the gums was lefs perceptible,
and they had now no offenfive fmell. (Venus femel.j
EXPERIMENT
( III )
EXPERIMENT V.
Diet t Bread and Water ; with roajied Goofe.
o
*T3
State of the at-
Daily allowance
Daily lofs of
Number and to-
Weight of my
N £
mofphere during
of food.
Weight.
tal weight of
body at the end
4-» ©
the period.
ftools.
of the period.
S«
•
Is
Thermometer
Bread, 30 oz.
40Z.
1 ftool, weighing
nft. 13 oz.
from 47 to 52.
Roafted Goofe,
9 oz. 6 dr.
T3 J5
Weather cloudy
6oz.
■
U 1)
or rain.
Water, 3 lb.
CkJ=
■5 »°
Daily gain in
weight.
o
SO
•> o
Thermometer
Bread, 30 oz.
3 oz.
Loofe ftools.
11 ft. 131b. »2 oz.
"O r-
o •£
_ —
Roafted Goofe,
Weather com-
6oz.
CL,
monly ferene.
Water 3 lb.
\
<JZ
JG
o t-
Daily lofs of
U .a
J3 O
weight.
= «
i2
Thermometer
Bread, 30 oz.
3 oz.
Loofe ftools.
lift. 131b.
about 50.
Roafted Goofe,
.2 ■*"
Weather ferene.
6oz.
-Ho
Water 3 lb.
■»
„c
p
•
Firft
112
"~
■ * ■ ' "■ ■
—» » - — ■■■-■ —
"*J
State of the at-
Daily allowance
Daily lofs of
Number and to-
Weight of my
— : ,0
mofphere during
of food.
weight.
tal weight of
body at the end
■" c
•g <5
the period.
flools.
of the period.
PO
- o
Thermometer
Irregular.
3 oz.
12ft. lib. 40Z.
•o J:
about jo.
Loofe ftools.
Weather ferene.
3 °
k
-C
Daily gain of
On .
weight.
~ o
s2
Thermometer $6.
Bread, 30 oz.
2 loofe ftocls.
12ft. i lb. 8 oz.
Weather cloudy.
Roafted Goofe,
■tt «
8oz.
1 I
Water 3 lb.
CLJ3
—
ten
REMARKS.
I had fucked blood from my gums till the 3d of October, but none
afterwards ; the fvvelling of the gums of the upper jaw had fubfided,
and they feemed to be quite well, whilft thofe of the lower jaw were
daily mending ; in every refpect I was hearty and vigorous botli in
body and mind. (Venus ter.)
On the 7th, I had a head-ach, and little appetite for food.
One loofe ftool.
On the 8 th, had two loofe flools ; my gums were rather worfe,
and I brought away a little blood by fucking them.
Between
( w )
Between the ioth and 14th had two liquid flools ; my gums
quite well. (Venus bis.)
From the 14th to the 19th, lived freely on animal food.
From the 19th to the 21ft, was fometimes a little thirfty, and
my appetite was rather more than fatisfied -} violent deiires ; paffed
a good deal of wind downwards. (Venus bis.)
EXPERIMENT
( "4 )
EXPERIMENT VI.
Diet of Bread and Water, with boiled Beef . M
t'irit period, from the 21ft to
the 24th of Odober.
State of the at-
niofphere daring
the period.
Thermometer
from 47 to 54.
Weather ferene
or cloudy.
Daily allowance
of food.
Bread, 30 oz.
Boiled Beef, 6 oz.
Water, 3 lb.
Weight of my
body ftationary.
Number and to-
tal weight of
ftools.
1 ftool, weigh-
ing 4 oz. 5 dr.
Weight of my
body at the end
of the period.
1 2 ft. 1 lb; 8 oz.
"Second period, from the 24th
to the 28th of Oftober.
Bread, 30 oz.
Boiled Beef, 40Z.
Water, 3 lb.
1
1
weighing
9 oz. 12 dr.
-
REMARKS.
Of the beef, nearly a third part was fat. I found fix ounces too
much for one meal, and therefore I divided it into two. (Venus bis.)
Upon the allowance of four ounces, I did not find my appetite
fufHciently fatisfied, although I paffed lefs wind downwards than
when I ate the fix ounces. I was never in the leaft heavy or dull
after any meal -> had no venereal defires, but a keenefs for iludy.
I fometimes infufed fome flowers of lavender, or rofemary, 'in the
water I ufed, but found nothing fo agreeable as green tea.
A Repetition
( "5 )
A Repetition of EXPERIMENT II.
Diet of Bread and Water with Sugar.
oo
u
1
State of the at-
mofphere during
the period.
Daily allowance
of food
Number and to-
tal weight of
ftools.
Lofs of weight at
the end of the
period.
M
U
a.
es
Thermometer
from 48 to 52.
Weather cloudy,
with much rain.
Bread, 30 oz.
Loaf Sugar, 6oz.
Water, 3 lb.
-
2 firm ftools,
weighing 6 oz.
9 dr.
lib.
hi
y
x>
o .
^ aj
•
Encreafe of
weight at the
end of the pe-
riod.
-o1=
O D
c
o
o
CO
Thermometer
from 53 to 55.
Weather rainy.
Bread, 30 oz.
Loaf Sugar, 6oz.
Water, 3 lb.
i very firm ftool,
weighing 30Z.
J dr.
1 lb.
■
REMARKS.
Being now in perfect health, and my gums apparently found, I
thought it a proper time to afcertain, by experiment, whether
the affection of my gums, and the other complaints with which
I had formerly been attacked, were occafioned by fugar, or were
owing to my having perfevered too long in a diet of bread and
water.
QjS
On
( "6 )
On the 28th, I brought up a good deal of wind off my flomach,
after each meal; on the 29th a little; but on the 30th none.
I paffed fcarcely any downwards, and what I did pafs, was much
lefs fetid than when I lived on beef. My appetite was furiiciently
fatisfied, and, excepting on the firft day, that I perceived a little
clamminefs in my mouth, I was not in the leaft thinly.
During the fecond period, or the two laft days, there hap-
pened a great irregularity in my weight, for which, not having
attended to the quantity of my urine or perfpiration, I can af-
fign no reafon. My weight was encreaied 1 lb the firft day, and
was leffened 2 lb the next. My appetite was hardly fatisfied ; I
was never thirfty. I paffed a little wind downwards, not at all fe-
tid. I had no defires. My gums were not in the leaft af-
fected.
A Repetition
( H7 )
A Repetition of EXPERIMENT VI.
Diet of B ready with boiled Beefy and Water.
■^r
State of the at-
Daily allowance
Number and- to-
Increafe of
"1
mofphere during
of food.
tal weight of
weight at the
the period.
ftools.
end of the pe-
1-. •
riod.
u
> -
Thermometer
Bread, 30 oz.
from 93 to 55.
Boiled Beef.i part
4 pretty firm
1 lb. 8 oz.
5
Weather rainy
of which was fat,
ilools, weighing
and cloudy, fel-
6oz.
1 lb. 1 oz. 3 dr.
.2
dom ferene.
Water, 3 lb.
PL*
REMARKS.
On the firft day of this period I brought ofTa little wind from ray
itomach, and was fomewhat griped, with noife in my bowels. In
the evening, and during the night, I paifed a vail deal of wind down-
wards.
On the fecond day I was lefs troubled with wind, and on the third
and following days hardly at all. My appetite was not perfectly fa-
tisfied, but my fpirits were fomewhat raifed on the firft day, and
afterwards continued better than when I lived on fugar.
On the third day of this period I began to have defires, which
were confiderable in the night.
On the fifth day, Venus femel. Having every day, during this
period, paid particular attention to the weight of the body, I ob-
served that the principal increafe of weight was on the three laft
days.
EXPERIMENT
( ii8 )
EXPERIMENT. Vllf.
Diet of Bread, with only the lean Part of boiled Beef and Water,
Firft period, three days, Nov.
8, 9, 10.
State of the at-
mofphere during
the period.
Thermometer
from 49 to 54.
Weather rainy
and cloudy the 2
firft days; the
laft it was ferene.
Daily allowance
of food.
Bread, 20 oz.
The lean ot boiled
beef, 1 2 oz.
Water, 3 lb.
Number and to-
tal weight of
ftools.
1 ftool, weighing
1 lb. 6 oz.
Lofs of weight at
the end of the pe-
riod.
3 lb.
Second period, three days,
November 11, iz, 13.
Thermometer
from 4c to 47.
Weather fair the
2 firft days, rainy
the laft.
Bread, 1 lb.
The lean of boiled
beef, 1 lb.
Water, 3 lb.
t large thin ftool
on the morning of
the nth
-
lib.
C/> ,
-a ™
v. ■"
.2 S
S.1
i_ 0
Thermometer
43-
Weather ferene
the two firft days,
cloudy the laft.
Bread, 9 oz.
Theleanof*ftew-
ed beef, 1 8 oz.
Watery lb.
5 thin ftools,
weighing about
i lb.
r
3 lb.
f From this time I made ufc of the Avoirdupois weight only.
* Although the beef isfaid to have been Jicwed during the third period, this circumjlance
does notfeem to me to make any alteration in the Experiment^ as Dr. Stark did not ufe the gravyy
and his meat was but badly cooked.
REMARKS.
( "9 )
REMARKS.
My appetite was by no means fatisfied during either the firft
or fecond period. I fcarcely patted any wind either way. My
fleep was fomewhat difturbed by dreams. I had flrong defires.
(Venus bis)
On the firft day of the laft period, before I was attacked with
the purging, my appetite was hardly fatisfied with a meal, con-
fifting of eight or ten ounces of beef, and about half as much
bread — I became hungry a few hours afterwards, had frightful
dreams in the night, and awoke feveral times with palpitation at
the heart.
Having obfervect fome pieces of the beef pafs through me un-
digefted, I imagined that the purging was owing to the beef I
had ate, being tough and badly drefled ; for I had not yet learnt
the time that was neceflary to prepare it properly.
By repeated trials I found, that fix or feven hours of the boiling
heat was neceffary to make the beef tender ; that by this time
one third of the meat which was put into the inner pan, with-
out any water, was gravy, or a fluid, which congealed on cool-
ing, whilft two-thirds only remained folid. In preparing feveral
pounds of meat at a time, there was only the lofs of a few
drachms in the weight, which, I imagine, was chiefly air, as I
obferved many air-bubbles to arife through the gravy. Finding
it impoflible to feparate entirely, all the fat from the lean, when
raw.
( 120 )
raw, the oil which rofe to the furface in preparing the beef, was,
when cold, carefully removed.
■iHWJirwyp-M
N. B. Dr. Stark, during the two Jirfi periods of this Experi-
ment, had the boiled beef from an eating- houfe, but for the lafl
three days it was drefjed at home, in a clofe veffcl, of which he
gives the following dtfcription. " 'The vefjel in which the beef was
cooked, and which I employed afterwards in preparing all my food,
was a tin pan, of a cylindrical form, about three inches in dia-
meter, and capable of containing about three pints and a half,
wine meajure ; this pan had a clofe cover, and was fufp ended in
another of the fame flmpe, about two inches deeper a?id wider ;
the intermediate fpace being filed with water, before the vefjel was
put on the f re ■> the inner pan was, by this mea?2s, a kind of oven or
balneum Maria, in which the heat was always equal, and the
air excluded."
EXPERIMENT
( 121 )
EXPERIMENT VIII.
Diet, Jiewed Lean of Beef with the Gravy and Water,
g
2 *
~0 00
y -a
PS
State oftheatmo-
fphere during the
period.
Thermometer
from 39 to 40.
Weather, for the 3
firft days ferene
or cloudy, on the
laft rainy.
Daily allowance
of food.
Stewed beef, 20
oz. befides the
gravy.
Water 3 lb.
Number and total
weight of ftools.
1 foft ftool on -the
19th weighing 3
oz. 7 dr.
Lofs of weight at
the end of the pe
riod.
2 lb.
REMARKS.
In two or three hours after a meal of ten or twelve ounces of
meat with its gravy, I became hungry, and was particularly fb
every night at bed-time. I never had any wind in my ftomach,
and very feldom paiTed any downwards. My fpirits, at all times
very good, were fomewhat raifed after each meal; but my fleep
was every night difturbed by dreams, a circumftance which was
new to me. I commonly awoke very early in the morning, and found
myfelf lively and well refrellied : and although I had not flept my ufual
time, I was never drowiy of an evening. I had fometimes weak
defires at the beginning of this period, but none afterwards. My
ftools refembled in colour, the rufl of iron.
N. B. I tried at this time to leflen my ufual allowance of watery an experiment
which I had fometimes made before, but I found that it could not be done without
occafioning great thirft.
R EXPERIMENT
( 122 )
EXPERIMENT IX.
Diet, Jlewed Lean of Beef with the Gravy, Oil of Fat or Suet,
arid Water.
-u
o -a
c s
State of the at- IDaily allowance
mofphere during! of food,
the period.
Thermometer
from 43 to 46
Weather variable,
the 22d rainy.
tn
Stewed beef, 20
oz. befides the
graiy.
Oil of fat, 7 oz.
Water 3 lb. 4 oz.
Number and to-
tal weight of
(tools.
1 loofe ftool,
weighing 10 oz.
7 dr.
Lofs of weight at
the end of the pe-
riod.
1 lb. 2 oz. 8 dr.
Thermometer 43.
Weather cloudy,
with rain.
Stewed beef, 20
oz.
Oil of fat, g oz.
Water 3 lb.
2 loofe ftools,
weighing 1 lb.
lib. 1
-a
IE
r-
Thermometer48.|Stewed beef, 24
Weather cloudy,
with rain.
Oil of fuet, 1 oz
Water, 3 lb.
1 thin ftool,
weighing 8 oz.
8 dr.
7 oz.
REMARKS
I23
REMARKS.
Having already afcertained the nutritious quality of olive or vegetable
oil, joined with bread, I was defirous of trying if animal oil,
when taken with the lean part of meat would have a fimilar
effect. The firft day I took only four ounces of oil, obtained from
the common, or outfide fat. The fecond day I took fix ounces,
and the third day I took ten ounces of oil procured from fuet.
It did not difagree with my ftomach, although it was not inti-
mately mixed with the foup*, but floated on the furface of it—
I, however, had fome wind in my ftomach ; and, being thirfty,
was obliged to encreafe my ufual quantity of water.— I flept
longer, and more quietly than formerly, and was more difpofed
to be drowly than when I lived on the lean of meat only.
N. B. I found that of beef fuet, feven-eighths was pure oil or tallow, whereas the
common, or outfide fat, did not yield above two-thirds of oil, one-third being mu-
cilage or cellular fubftance. The mucilage diflblved readily in water, and formed
a jelly with it, but both mucilage' and cellular fubftance, when feparaled from the oi],
were extremely offenfive to the fmell and tafte.
* Dr, Stark's foup was a little warm water, added to the gravy of the meat.
R2 EXPERIMENT
(.124 )
EXPERIMENT X.
Diet of Flour, Oil of Suet, Water and Salt.
>
o
Z 6
state of the at-
Daily allowance
Difcharges by
Encreafe ofweight
mofphere during
of food.
ftooland urine.
at the end of the
« c*
the period.
period.
-a <s
2 foft ftools,
> oo
Thermometer
Flour, 20 07..
weighing 9 oz.
7 lb. 15 oz.13 dr,
«3 N
from 45 to 48.
Oil of fuet, 6 oz.
12 dr.
l^
Weather, much
Water, 4 lb.
<D .,
rain on the 26th,
Salt, 12 dr.
Ov,o
the other days
ferene or cloudy.
CO
Thermometer
Food as above*
Urine, 5 lb. 13 oz.
•
Lofs of weight,
CIS
13
4; and 43.
2 foft ftools,
3lb. 1 4 oz.13 dr.
2 w
weighing 1 lb.
g .
Weather ferene,
10 oz.
or cloudy.
T3 <u
o "
u
in
1
Thermometer
No food.
Urine, 3 lb. 1502,
Lofs of weight
u
42.
3 lb. 7 oz. 10 dr.
E
tu
Weather cloudy.
u
Q
-a
o
i_*
U
Oh
-a
E
h
i
Q .
Thermometer
Flour, 20 oz.
Urine, 10 lb,4oz
Encreafe of
•s OO
from 41 to 44.
Oil of Suet, 4 oz.
2 foft ftools,
weight 4 lb. 1 1
T3 -
Weather ferene,
Water, 4 lb.
weighing 1 lb.
oz. 6 dr.
or cloudy, rain
Salt, 12 dr.
7 oz. 5 dr.
<5 ^
on the 6 th.
O tH
o
in-
REMARKS.
( te* )
REMARKS.
I began the preceding Experiment with a view of comparing
the nutritious and other qualities of flour with thcfe of the lean
of meat. The quantity of tallow ufed in both Experiments was
nearly the fame, the quantity of water was regulated by the thirfr,
and varied from 3! Ifo to 4! lb. In this laft Experiment, the tal-
low and flour were intimately united, being made into a pudding,
with twelve and fometimes twenty ounces of water, the allow-
ance of water ufed as drink being lefiened in proportion.
On this diet my appetite was fufficiently fatisfied, I was eafy in
my bowels and flept very quietly. I obferved, however, that
the quantity of fat was too great, as a confiderable part of it
pafTed through me undigested in the form of granules. Venus
feme! during the firft period. I remarked alfo a great inequality
in the encreafe of the weight of my body. On the firft day
the encreafed weight was 1 Vb 15 oz.8 dr. — on the fecond, 1 lb 15 oz.
— on the third, 2 lb 13 oz. 4 dr. — on the fourth, 10 oz. 4 dr. — on the
fifth, 10. 13 dr. This great variation may have been partly
owing to the retention of the food in the inteftines during the
firft days of the period; and on the fecond day I drank more
water than ufual, which, probably caufed the great encrea
weight on the morning following.
During the fecond period I found the diet begin to dis-
agree with me -, I lofl my appetite, and was feized with fe-
vere head-achs, with uneafinefs at my ftomach and bowels, and
great part of the tallow pafTed through my body unaflimi-
lated. I was thirfty, and greatly troubled with wind, both up-
wards
( »6 )
wards and downwards. I alfo at this time obferved a considerable
encreafe in my urine.
Having been extremely uneafy during the night of thefecond of De-
cember, and having no appetite for food on the morning of die
third, I thought proper, though my appetite returned in the after-
noon, to abftain from food the whole day, and next morning
was quite well.
Sufpecting that the bad effects of the preceding diet were
owing to the quantity, and not the quality of the tallow, I di-
minifhed the quantity during the lafl period, and had then the
fatisfaction to find the diet agree with me perfectly well. My
bowels were quite eafy, and I was not troubled with wind,
with thirft, or with head-ach, and no part of the tallow re-
mained undigested.
The weight of my body was encreafed on the firfl day, 2 15
14 oz. 8 dr.— on the fecond, 1 lb 1 1 oz.— on the third, having had
a large ftool, there was a lofs of weight 5 oz. 9 dr. — on the fourth,
again an encreafe of 4 oz. 10 dr. — on the 5th, of 3 oz. 7 dr.
I mould, poffibly, have continued longer on this diet, which
I found both nourishing and agreeable, but wiihing to afcertain,
as exactly as pomble, the effect of the oil or tallow, I began the
following
EXPERIMENT
( i27 )
EXPERIMENT XI.
Diet of Flour, Water and Salt.
6
State of the at-
Daily allowance
Difcharges by
Lofs of weight at
"
mofphere during
of food
urine and itool.
the end of the
the period.
period.
Thermometer
Flour, 24 oz.
Urine, 17 lb.
from 42 to 48.
Water, 4 lb.
2 foft ftools,
5 lb. 6 oz. 5 dr.
aj —
Weather various,
Salt, 1 2 dr.
weighing 1 lb.
rain on the 10th
1 oz. 13 dr.
T3
.2
and nth, froft on
the 13th.
REMARKS.
On the firft day of this Experiment my appetite was pretty
well fatisfied, but afterwards, particularly towards the end of it,
I found that in two or three hours after a meal, confuting of
one half my pudding, I became hungry, and I was extremely fo
every night at bed-time.
On the former diet, with oil or fuet, four pints of water were
hardly fufficient to quench my thirft ; and, commonly, at bed-time,
I was obliged to fip a little more. On the prefent diet I was
never thirfty, and am perfuaded that I might at this time, with-
out inconvenience, have diminifhed my common allowance of
water, but I continued it nearly the fame for an obvious reafon,
viz. that I might judge with more accuracy of the effect of the
fuet or oil joined with the other parts of my food.
Whea
( i*8 )
When the pudding was made with fuet, I found the one half
of it rather too much for one meal -, whereas when it was made
without fuet, I fometimes thought that I could eafily have ate
the whole at one time. Whilft I lived on a pudding made with
oil or luet, I felt no inconvenience from retaining my water the
whole night, but on the prefent diet, I found it very dif-
ficult and even painful to do fo ; and feveral times whilft I was
engaged in the morning, in obferving the nocturnal perforation,
a little urine run off involuntarily. My foeces were, during this
experiment, of an orange colour, during the former of a buff
colour, and were of a ftill lighter colour when the proportion
of fat was greater.
I loft in weight, on the firft day, 5 oz. 6 dr. — on the fecond,
10 oz. 3 dr. — on the third, 1 15 3 dr.— «on the fourth, 1 lb 10 oz.
7 dr. — on the fifth, 1 lb 12 oz. 2 dr. thus when the body was not
properly nourifhed, the lofs of weight was greateft on the laft days
of the Experiment, but when the body was more than fupported,
the encreafe of weight was greateft on the firft days of fuch a re-
gimen. I alfo remarked, that the encreafe of urine, was nearly,
though not exactly, in proportion to the decreafe of the weight
of the body.
A Repetition
( 129 )
A Repetition of EXPERIMENT X.
Diet of Flour, Beef Suet, Water and Salt.
State of the at-
mofphere
Thermometer
45-
Weather cloudy,
with rain.
Allowance of
food.
Flour, 24 oz.
Suet, 40Z.
Water, 4 lb.
Salt, 12 dr.
Difcharges.
Urine, 2 lb. 12 oz.
Gained in weight
90Z. 1 5 dr.
REMARKS.
To afcertain more fully the effect of fuet in my pudding,
I again repeated it for one day, and obferved, as formerly, that
my appetite was fatisfied with half the quantity, and that I was
not hungry until five hours after my ufual meal. I was a little
thirfty after dinner, and my urine was one pint two ounces
lefs inquantity than on the preceding day.
EXPERIMENT
( *3° )
EXPERIMENT XII.
Diet of Flour, frejh Butter, Water and Salt.
State of the at-
niofphere.
Allowance of
food. ■
Difcharges.
Lofs of weight.
H
S
u
Q
Thermometer 45.
Weather rainy
and cloudy.
Flour, 24 oz.
Butter, 4 02.
Water, 4 lb.
Salt, 1 2 dr.
Urine, 2 lb. 7 oz.
2 liquid ftools,
weighing 1 lb,
1 lb. 30Z. 10 dr.
REMARKS.
Finding that the refult of the Experiments with fuet, or ani-
mal oil, correfponded very much with thofe I formerly made with
oil of olives, a vegetable expreffed oil, I was defirous of extending
my enquiry to other oily fubfhnces. I began with frefh butter,
which I imagined might Mdy be taken in the fame quantity
as fuet or oil of beef, but foon after dinner, which was this day
my fecond and lail meal, I became uneafy at my ftomach, brought
up fome wind and had pain in my bowels, and foon afterwards
had two thin /tools, accompanied with considerable heat in the
fundament, draining, and even with fweating and trembling. I
was extremely ill all the evening, and continued very uneafy in
my bowels, and with a pain in my fundament during the whole
of the night.
EXPERIMENT
■ ( w )
EXPERIMENT XIIL
Diet, Yolks of Eggs, Suet, Figs mid Water.
State oftheatmo-
fphere during the
period.
Allowance of
food.
Difcharges.
Lofs of weight
1-1
6
V
U
a
Q
Thermometer
Weather fair and
ferene.
Yolks of eggs,
Suet, of each 4
oz.
FigSj 1 lb.
Water 4 lb.
Urine, 3 lb. 14
oz.
1 liquid ftool,
weighing 4 oz.
6 dr.
13 oz. 10 dr.
REMARKS.
Difappointed in the eftecT: of butter, and not having pro-
vided any other food, I was this day Tome what irregular ; wifh-
ing to know the precife efreci of flour, and to have fome means of
judging of the fhare which it had in the preceding nourifhing diet,
I had, for fome days, been trying to unite or combine fat and
water, by means of fome mucilaginous fubftance, imagining that if
they could be retained in the body, they would, perhaps, fupply a
fufficient nourimment without the flour. Gum Tragacanth, which is
the flrongefl vegetable mucilage, a jelly of calves feet, whites of eggs,
and the yolks ■ of eggs, were tried, in various proportions, the laffc
anfwered the beft of any, although it did not form a complete union
- between the fuet and water. I breakfafted on the quantity men-
tioned in the tabkj, with two pints of warm water, imagining
S 2 that
( 132 )
that the flomaeh and bowels would pofiible complete the
union.
After breakfaft I became fomewhat uneafy at my fti-mach,
and in two hours had a liquid ftool, refembling exactly the
food I had taken, and which contained fome of the clear
melted fat, not united with the water or egg. I had no pain
in my bowels, or {training with this ftool, as with thofe occa-
fioned by the butter, and I was ibon hungry My urine alfo,
was greatly encreafed after the above liquid meal.
I likewife tried, if by coagulating the yolks of eggs, and conti-
nuing the heat for feveral hours, it was poffible to unite the tallow
more intimately, but in this I was difappointed, and the mefs was
fo difagreeable, that, after tailing it, though I was extremely
hungry, I could not eat it, and therefore dined on one pound of
figs, with two pints of tea, which was a very agreeable meal,
and' I did not become hungry again till after five hours.
EXPERIMENT
( '33 )
EXPERIMENT XII. varied
Diet of Flour, Butter, or Oil of Butter, Water and Salt,
GO
State of the at-
mofphere during
Daily allowance
of food.
Difcharges.
Gained in weight
at the end of the
the period.
period.
u O
8 Ov
Thermometer
Flour, 24 oz.
Urine, 1 1 lb.2 0z.
1 lb. 7 oz. 3 dr,
from 44 to 49.
Butter, or oil of
2 thin ftools, on
Weather, vari-
buUer, 4 oz.
the 19th,
able, rain on the
Water, 4 lb.
weighing 1 lb.
-a
o
r w
W
r
1 8th.
6 oz. 9 dr»
REMARKS.
Sufpecting, that the butter not having been intimately com-
bined with the flour and water, in the firft Experiment, was
the reafon of its difagreeing with my ftomach and bowels ; and
being alfo perfuaded, that though in this way, it was found
to difagree with the ftomach, yet the oil of butter, feparated
from the other parts, and taken by itfelf, might not have
the fame effect ; I was defirous of afcertaining both thefe
facts : and therefore, in the preceding Experiment, I employed
frem butter, and oil of butter alternately, both of them being
mixed up with the flour and water into a pudding.
On the 17th, in the morning, I was quite well, and had a
good appetite for breakfaft, but I had no appetite for dinner,
and
( '3+ )
and ate my pudding, made with butter, with relu&ance. After
dinner I was drowzy, thirfty, and obliged to drink half a pint
more than my allowance. I had confiderable uneafinefs in my
bowels, with fome wind downwards, but no tiool.
On the 1 8th, when I ufed the oil of butter, I had a very
good appetite for dinner, and no thirft, or uneafinefs in my
i bowels after it, although I pafTed a good deal of wind.
On the 19th, when I again employed butter, I was thirfty,
uneafy in my bowels, and had two loofe flools, with trainings
and pain in my fundament.
On the 2cth, when I made ufe of oil of' butter, my appe-
tite was very good, and I had very little thirft, or uneafinefs in
my bowels, but ilill I was not quite fo eafy as I had been when
I ufed the fame quantity of the oil of fuet.
JEXPERIMENT
( us )
EXPERIMENT XIV,
Diet of Floury Oil of Marrow, Water and Salt.
State of the at-
Daily allowance
Difcharges.
Encreafeof
J5
E
mofphere during
of food
weight.
11
the period.
Q N
• N
Thermometer
Flour, 24 oz.
Urine, 4 lb. 6 oz.
1 lb. 4 oz, 2 dr.
O _
o
Oil of Marrow ^
Weather
4 oz.
Ph
o
Water, 4 lb.
^
Salt, 1 2 dr.
E
y
Thermometer
Flour, 24 oz.
Urine, 71b. 12 oz.
1 lb, 40Z, 13 dr.
g
o
Oil of Marrow,
2 foft ftools,
n ^
Weather
6 oz.
weighing 1 lb.
1> N
Q -
o
Water, 4 lb.
2 oz. 1 dr.
Salt, 12 dr.
a,
-a
c
o
u
u
c/0
REMARK S.
Marrow, by gentle Heat and preffure, yields about 44 of a
pure oil, much pleafanter, both to the tafte and fmell, than
the oil obtained from fat or fuet. This oil was combined,
as ufual, with flour and water, into a pudding; with which,
though my appetite was fufficiently fatisried, yet I was hungry
for
( '36 )
for each meal. I was not in the lead thirfly, was eafy in
my bowels, brought up no wind, and pafTed none down-
wards. I found myfelf remarkably well on this regimen, and
thought my fpirits raifed by it ; though this might be only
opinion, as it is difficult on fuch Subjects to diftinguim between
fancy and reality. I fometimes had defires. Venus femel, during
the hril period,
Finding the oil of marrow fo mild in the bowels, and at the
fame time fo agreeable a food, I encreafed the quantity, to judge
ftill further of its effects, and particularly to determine whether
the degree of nourishment, or rather of encreafe in the weight
of the body, was in proportion to the quantity of nourishment
taken.
I had a Stool on the 25th, and another on the morning of
the 261th, but in neither could I perceive any granules, as was
the cafe when I ufed the fame quantity of fat or fuet.
I continued perfectly eafy until the 26th, when I felt myfelf
fomewhat dull before dinner, brought up fome wind, and had
little or no appetite. In the evening I was very drowfy and
thirfty,. and obliged to drink half a pint more than my common
allowance of water, but on this, and even on the preceding day,
the angles of feveral of the gums were purple, and a little
dwelled. Venus femel.
EXPERIMENT
( 137 )
EXPERIMENT XV.
State of the
Diet irregular.
Difcharges.
Weight of the bo-
.
weather.
4 of a pudding
Urine,2 lb.iooz.
dy in the morn-
o
made with 6oz.
i ftool, weigh-
ing.
1*
of fuet.
ing g oz.
i oft. 131b. 9 oz.
6
u
Water, or tea,
6 dr.
1
2 lb. 6 oz.
Q
Black currants.
8 oz.
REMARKS.
As the oil of marrow feemed to be lefs nutritious than that
of fuet, I purpofed, in order more exactly to afcertain the fact,
to have again taken the' fuet for two or three days, particu-
larly as I wifhed to clear up a doubt which I Hill entertained, viz.
whether the fame food, or food of the fame nutritious power,
taken when the body is in a low ftate, may not raife it farter than
if taken when the body is in better condition. When I flrffc
began to ufe the fuet my body was extremely low, which was
not the cafe when I began to ufe marrow, and therefore, to this
circumftance, poffibly, may be afcribed, the apparent difference of
their nutritious powers. I was, however, prevented making this
Experiment, by having no appetite in the morning ; and, though I
forced myfelf to eat part of a fuet pudding for breakfaft, I could
take no more food, during the day, and fuffered much, unealinefs
T fronv.
( '38 )
from wind in my bowels. In the evening I was eafier, and ate
half a pint of black currants. I was determined alfo, by the
appearance of my gums and fkin, to change, for fome little time,
my plan of living.
Although upon my pudding diet, I had in general pretty
good fpirits, yet I fancied that I was not fo lively as ufual,
nor fo active and vigorous, either in body or mind.
N. B. As Dr. Stark made no abjlraB of his journal after the 26th
of December •, the "Editor has endeavoured to fupply this lofs from the
original journal in his pojjejjion.
EXPERIMENT
( »39 )
EXPERIMENT XVI.
Diet. Bread, with roq/ied Fowl, Infujionof Tea and Sugar.
Day of the
*State of the
Allowance of
Difcharges by
Weight of my
Month,
Weather
food
ftool and urine.
body,
December 27.
Serene,
Bread, 2 lb.
Urine plentiful.
10 ft. 9 lb.
Rainy,
Roafted fowl,
1 large ftool.
90Z. 1 4 dr.
Cloudy.
8 oz. with a
little fait,
Infufion of tea,
fweetened with
fugar, 3 lb. 9 oz.
*8,
Rainy,
Bread, 2 lb.
Urine, 3 lb. 3 oz.
10 ft. gib.
Cloudy,
Roafted fowl,
r 3 oz. 1 0 dr.
Variable,
12 oz. 3 dr.
'
Tea, 3 lb. 9 oz.
REMARKS.
Dec. 27. I ilept quietly, and awoke this morning, at my ufual
time, hungry and perfectly eafy. Immediately after getting up I had
a buff-coloured ftool. Was not my indifpofition of yefterday oc-
casioned, by my having rather imprudently encreafed, and perfevered
too long in the ufe of the oil of marrow ? which, when taken
in a moderate quantity, fcems, of all fats, the mildeft in the
bowels.
* Dr. Stark, from this time, feems to hive paid no attention to the thermometer*
though he has noticed the weather with particular accuracy.
T 2 This
C 140 )
This morning I obferve the gums of the double teeth, on each
fide of the upper jaw, confiderably fwelled, of a purple colour, an(^
fome of them, almoft black at the corners ; they are, likewife, hot
and painful ; thofe of the left fide bled on my biting a bit of bread.—
The gums of the lower jaw appear to be quite found. Moft of the
goofe-fkin eminences on my legs and thighs are of a deep red, fome
of them purple ; and the difcolouration, which extends even beyond
the eminences, is fomewhat brownifh at the edges. Under my left
bread there is alfo a true petechial fpot, having the fame appearance,
as formerly during my fevere illnefs.
It is worthy of being remarked, that after I had lived for fome
time, on animal food entirely, although I was reduced lower in
weight, in ftrength, and in fpirits, than at prefent ; yet there were
no fuch appearances. Is it not probable, then, that animal oils,
though they nourifh and encreafe the weight of "the body, are not
of themfelves fufficient, to prevent a morbid alteration from taking
place in the blood and fluids ? Whilft, on the other hand, the lean
of meat, though lefs nutritious, is of more efficacy in preferving
the fluids of the body in a found flate ? Notwithstanding, however,
what I have obferved of my gums, and the eminences on my
legs; my countenance, and fkin in general, has the appearance of
health.
My food, this day, I found quite fufficient to fatisfy my appe-
tite. I had a little wind both upwards and downwards.
28th. When I awoke this morning, I perceived a difagreeable,
fweetiih tafte in my mouth, and my gums had an offenfive fmell ;
in other refpects I was much as yefteiday. Towards evening my
gums were confiderably eafier and better, but I was attacked with
a fevere cholic, which continued moft of the night.
EXPERIMENT
( Hi )
EXPERIMENT XVII.
Diet. Bread, fewed Lean of B erf, with the Gravy, Infufon of Tea*
with Sugar.
Day of the
month.
December 29.
30
3»
Jan. 1.
State of the
weather.
Variable,
Serene,
Ditto.
Allowance of Difcharges by
food. urine and ftool.
Stewed beef,
&c. 1 lb.
Bread, 2 lb.
Tea, 3 lb. 9 oz
Urine, 3 lb. 7 c%.
♦Weight of the
body.
io ft. 10 lb.
7 oz, 6 dr.
Variable,
Snow,
Rain,
Food, ditto.
Urine, 2 lb. 13 1 10 ft. 12 lb.
oz. 9 oz. 13 dr.
Stool, 7 oz. 4 dr.
Variable,
Serene,
Ditto.
Food, ditto.
Urine, 4 lb.
10 ft. 12 lb.
90Z. 14 dr.
Cloudy,
Variable,
Cloudy.
Food, ditto.
Urine, 3 lb. 15
oz.
Stool, 8 oz.3dr
10 ft. 13 lb.
4 oz. 4 dr.
REMARKS.
* The weight was taken immediately after b reals faft,
( H2 )
REMARKS.
Dec. 29. I parTed an unpleafant night, having been either kept
awake by the pain of the cholic, or having my fleep difturbed by
difagreeable dreams. In the morning I had not fo much of the
fweetifh tafte in my mouth, my gums were paler, lefs fwelled, and
not fo offenfive to the fmell as on the preceding day j the fpots on my
fkin were alfo paler.
My appetite was not fufficiently fatisfied with four ounces of
meat for breakfaft, but I found that eight ounces at dinner, and four
at fupper, were rather too much for me. I had no uneafinefs in
my bowels, and pafled but little wind either way. At bed-time I
was thirfty, and drank a few ounces of water.
30. I flept quietly until an hour or two before day-light, when I
had a little disturbance in my bowels, but without pain, My gums
now fcarcely occafion any ofFenfive fmell or tafte. At dinner, be-
fides my ufual allowance of beef, &c. I ate- fome rice-pudding, with
melted butter, and drank two glaffes of wine. After dinner I had a
pain at the pit of my ftomach, but which went off upon my bringing
up a little wind. Before fupper I had a head-ach, but this went off;
alfo, after a firmftool, of a dark, earthy colour, attended with violent
ilraining ; a little before going to bed I was troubled with wind, and
a good deal griped.
31. My appetite is Satisfied with my prefent allowance of food,
which I find would not be the cafe were I at all to leficn it. I com-
monly
( 143 )
monly eat my beef cold, being more agreeable to me than when hot
My bowels are quite eaiy, I pafTed a little wind downwards, but
none upwards. My gums, though not livid as at firrl, are ftill
red, a good deal puffed up, are apt to bleed on being preffed with
the ringer, and are fo painful, that it is troublefome to me to eat even
the crumb of bread. This evening I perceive that the fpots on my
fkin are paler than they were in the morning. Alt hough the quan-
tity of my drink was the fame as formerly, my urine is to-day
confiderably encreafed. I obferve that the urine, collected during
the night, is much paler than what I make in the day.
Jan. i .Although I fleep quietly every night, yet my gums are ftill puf-
fed up, livid and uneafy ; and in the left fide, there is a fmall fmarting
fore, in a place from which a tooth was extracted fome years ago.
To-day I have been hungry for each meal, and was confiderably fo
after fupper. I am quite eafy and in good fpirits, with little or no
wind either way -, before dinner I had a firm ftool of a uniform dark
brownifh colour. Although, at prefent, I take more food than what
is abfolutely necefTary for the fupport of the body, I remain perfectly
well, whereas I have feveral times fuffered confiderable inconvenience
from committing any excefs in the quantity of oils. Is it not evident,
then, that an excefs in the ufe of oils, is more hurtful to the body,
than an excefs in any other article of food ? and that, of courfe, we
ought to be particularly careful in regulating the quantity and quality
of the oils we employ in diet.
EXPERIMENT
( H4 )
EXPERIMENT XVIII.
Diet. Bread, The Fat ofjiewed Beef, with the Jelly, Water and Salt.
Day of the
month.
Jan. 2.
State of the
Weather.
Cloudy,
Ditto,
Rain.
Allowance of
food.
Fat of beef,4 oz
Bread, 2 lb.
Water, 3 lb. 9 02,
Difcharges by
urine and ftool.
Urine, 4 lb. 6 oz. 1 o ft. 1 2 lb.
10 oz. i4dr.
Weight of the
body.
Cloudy,
Ditto,
Ditto.
Fat of beef, 4 oz.
Bread and water
as yefterday.
Urine, 31b. iooz
Stool, fo oz.6 dr
10ft. 13 lb.
6 oz. 2 dr.
Cloudy.
Ditto,
Snow.
Food, ditto.
Urine, 3 lb. iooz.
Stools,i 1 oz. 6dr.
10 ft. 13 lb.
6oz. 2 dr.
Serene,
Froft,
Ditto.
Food, ditto.
Urine. 21b. i2 0z.| 10 ft. 13 lb.
6oz. 2 dr,
REMARKS..
( H5 )
REMARKS.
Jan. 2. With a view to compare the effects of the fat of beef,
(which may be fomewhat different from the oil already tried) with
thofe of the lean, I began, this day, a courfe of Experiments with
the former. The fat which I ufed, was flewed with the lean of the beef,
feparated from it when cold, and ate, with as much of the jelly
as feemed to belong to it ; the pure oil, which had concreted on
the furface, was entirely removed. But, as the lean of flewed beef
had fome fat mixed with it, in like manner the fat has fome lean,
which renders the Experiment not fo complete as one I purpofe
making with boiled buttock of beef, of which I mall ufe the two
parts accurately feparated from each other •> but, previous to this, I
intend to try the effect, of greens and frefh fruit.
Is it not poffible, that a fmall quantity of fat may afford the
fame nourifhment as a larger quantity of lean, and may be fo pre-
pared as to be more eafily afiimilated by weak digefHve organs ?
Perhaps marrow, mixed up with panada, might prove a proper and
ufeful food for convalefcents.
This morning my gums were quite well, and the goofe-fkin
eminences on my legs were only of a pale red. I was hungry
for breakfaft, and made a very agreeable one, upon two ounces of
fat*, with bread and tea ; and, finding myfelf hungry fooner than
I expected after breakfaft, I took, for dinner, three ounces of fit,
which was alfo a very agreeable meal. In the evening I fupped on
U bread
* The fat as well as lean i always cat cold.
( H6 )
bread and tea. Iwas in excellent fpirits, much inclined to veneryy
to which I did not feel the fmallefc propenfity, whilfl living on the
lean of meat. I pafTed little wind either way.
3. (Venus bis.) My fleep was fomewhat difturbed in the
night by difagreeable dreams ; my appetite, to-day, has been very
well fatisfied until evening, when I felt myfelf hungry,
4. I was reftlefs "laft night, and had a frightful dream. A few.
hours after breakfaft I had a firm, dark brown ftool. The affection
of my gums ftill continues, although in a flighter degree than when
I began to eat meat.
5. -I flept well in the night, excepting that I was difturbed by
a dream, attended with an emiffion, a circumftance that has not hap-
pened to me above three or four times in my life. I was rather
dull after breakfaft, probably owing to my having ate too much
fat,
A Repetition "
( H7 )
A Repetition of EXPERIMENT VII.
■Diet, Bread, the Lean of boiled Beef, Infujion of Tea with Sugar ^
(no Salt*)
Day of the
month.
Jan. 17.
Sate of the
weather.
Serene, with
froft.
Allowance of
food.
Bread, 2 lb.
Lean of beef,
ilb.
Infufion of tea,
3 lb. 9 oz.
Difcharges by
urine and ftool.
1 ftool, weigh-
ing 4 oz. 4 dr.
" ■
Weight of the
body.
1 1 ft. 3 lb.
13 oz.4 dr.
18.
Cloudy,
Snow,
Rain.
Food, ditto.
Urine, 4 lb.
Stool, ilb. 40Z.
12 dr.
n ft. 1 lb.
8 oz. 6 dr.
19.
Rain,
Serene,
Cloudy.
Beef, 12 oz.
Bread, as above.
Urine, 2 lb.
14 oz.
11 ft. 11 lb;
12 oz. 10 dr.
20.
Cloudy,
Ditto,
Ditto.
Beef, 14 oz.
Bread, as above.
Urine. 3 lb.
1 1 ft. 3 lb.
1 oz. 8 dr.
u2
REMARKS.
* Sir John Pringle' having a fufpicion that the large quantity of fait which I formerly
ufed, might occafion the affection of my gums; I -omitted it entirely in the prefent
Experiment,
( 148 )
REMARKS.
Having, fincethe5th, been engaged in a canvas for St. George's
Hoipital, I have been very irregular in refpecl: to diet, living ra-
ther more freely, and drinking more wine than ufual. I have
alfo walked a good deal ; but, upon the whole, have been ex-
tremely well in health, excepting one night, when, from a defire of
preventing hunger the next morning, I ate too much fat for
fupper. I have had commonly one foft ftool a-day. My gums
are quite firm and well, and the goofe-fkin eminences are of the
natural colour of the fkin. The weather has been, in general,
fevere, with froft and fnow, until within thefefew days^ when it
has been a little milder.
17. My appetite, this day, has been rather more than fatis-
fied. I palled a good deal of wind downwards, and, before fupper,
had a fmall firm ftool.
18. Early this morning I felt confiderable uneafinefs in my
bowels, had a ftool, the latter part of it thin. Had no appetite
for fupper, which I would rather have omitted; very dull all
day ; took [no exercife till the evening, had then a good deal of
pain in my belly, and was greatly troubled with wind.
19. I was ftill low-fpirited and dull, but this was, poftibly,
in part, owing, to my having but fmall hopes of fuccefs at St.
George's
( *49 )
George's Hofpital. I had fome disturbance in my bowels in the
morning, and again in the evening, attended with pain. My
appetite was rather more than fatisfied, and I had fome flight
defires.
20. I went to bed foon after fupper, dreamt in the night,
though not frightfully ; palled a good deal of wind before I got
up ; ufed a good deal of exercife in the morning, and break-
fafted three hours later than ufual. I find my appetite more
than fatisfied, and 1 am now quite eafy in my bowels.
EXPERIMENT
( *$° )
EXPERIMENT XIX.
Diet. Bread, Fat of boiled Beef , Infufion ofT?ea with Sugar,
Day of the
month.
Jan. 21.
State of the
weather.
Cloudy,
Variable.
Serene.
Allowance of
food.
Fit of boiled beef,
3 oz.
Bread, 2 lb.
Tea, 3 lb. 9 oz
Difcharges by
urine and ftool.
Urine, 2 lb. 9 oz
Stool, 9 oz. izdr,
Weight of the
body.
1 1 ft. 4 lb.
9 oz. 12 dr.
22.
23.
Cloudy,
Serene,
Rainy.
Cloudy,
Serene,
Ditto.
Fat, 2 oz.
Bread,&c. ditto.
Urine, 3 lb.
Food, ditto.
Urine,i lb. 13 oz.
1 1 ft. 3 lb.
3 oz. 1 3 dr.
1 1 ft. 4 lb.
iooz. 10 dr.
24.
rene,
Ditto,
Ditto.
Fat, z\ oz.
Bread, &c. ditto.
Urine,
2 lb.
Stool, ^
oz. 8 dr.
1 1 ft. 6 lb.
2 oz. 3 dr.
REMARKS.
( i5i )
REMARKS.
Jan. 21. My morning urine was high-coloured, and became
turbid on {landing. This morning I walked a good way before
breakfafl:, and breakfafled an hour earlier than yeflerday ; my
bowels were fomewhat uneafy, and I paffed a great deal of wind down-
wards. The fat I ufe has been kept fome days fince it was boiled
but feems quite fweet ; I found two ounces rather too much f@r
breakfafl, [and I was under the neceffity of eating half my loaf
with it.
Before dinner I had a dark coloured flool, of a moderate con-
liftence; at dinner I could not finifh an ounce of fat. I had a
flight pain in my bowels after breakfafl ; and, although I had no
wind, was a little griped before I went to bed. In the night,
after fome fevere griping pains, I had a purging, dark-coloured,
flimy flool, which I apprehend to have been occasioned from
the fat (as it had been kept fome days,) being fomewhat ran-
cid, although this was not perceptible either to the fmell or
tafle. Poffibly, ,the fudden change of diet was partly the caufe
of it.
22. At breakfafl I could eat only one ounce of fat, and
that with reluctance, as the fat was foft and greafy, which is more
difagreeable than when firm and dry — I ate another ounce at
dinner, and although, from being harder, I ate it with lefs re-
luctance, yet I found it fully enough for my ilomach. As my
appetite
( *$* )
appetite was fully fatisfied, I ate no fupper. I was eafy in my
bowels and well in every refpecl:. (Had defires.)
23. (Venus femel.) I ate an ounce of hard fat for break-
faft, without reluctance, it was quite frefh, having been boiled
only two days before — I eafily ate the fame quantity at dinner—
I was perfectly eafy in my bowels, had no wind upwards, and
little downwards — Was fomewhat hungry at bed-time.
24. The frefh and friable fat became at lafr. to be almofl
as agreeable to me as butter. My appetite was not more than
fatisfied, and whilft ufing this diet I felt myfelf lighter, more
alert and eafier, than when living on the lean of meat only. I
had fcarcely any wind in my flomach — At twelve I had a light
yellow ilool of a moderate confiflence.
EXPERIMENT
( *S3 )
EXPERIMENT XX.
Diet. Bread, the Lean of roafted Veal, and Water*
Day of the
month.
Jan. 2j.
State of the
weather.
Cloudy,
Ditto,
Rain,
Allowance of
food.
Lean of roafted
veal, 1 2 oz.
Bread, 2 lb.
Water, 3 lb. 9 oz.
Difcharges by
urine and ftool.
Urine, 2 lb.
l\ oz.
Weight of the
body.
1 1 ft. $ lb.
1 2 oz. 4 dr.
j
26.
Rain,
Cloudy,
Serene.
Food, ditto.
Urine, 41b. joz.
r
-
ir ft. 4lb.
7 oz. 10 dr.
27.
Cloudy.
Ditto,
Ditto.
Breakfaft, roaft-
ed veal, 3 oz.
Dinner and
fupper irregu-
lar.
Urine, 3lb.i40z.
Stool, 5 oz. 8 dr.
1 1 ft. 3 lb.
15 oz. 14 dr.
REMARKS.
Jan. 25. I was very hungry for dinner, and immediately before
it had a ftool, partly coftive and partly loofe. May not a fudden
change of diet have an effecT: in opening the body, even though the
X change
( 154 )
change made, be from a kind of food naturally more opening, to
one that is lefs fo ? At bed-time I felt fome commotion in my
bowels, and paffed fome wind downwards.
26. I have dreamt for fome nights part. To-day I have brought
off wind, and feveral times fome fluff from my ftomach ; I have
likewife been drowfy, efpecially after dinner , I am eafy in other
refpecls, and my appetite not more than fatisfied.
37. I had defires in the night, but which went off upon empty-
ing my bladder. I dined and flipped abroad, and ate heartily of a
variety of different things, but, though I did not overload my fto-
mach, I was not fo eafy as ufual for fome time after I went
to bed.
EXPERIMENT
( *S5 )
EXPERIMENT XXL
Diet. Bread, Fat of Bacon Ham, Infujion of Tea, with Sugar.
Day of the
State of the
Allowance of
Difcharges by
Weight of the
month.
weather*
food.
urine and (tool.
body.
»
January 28.
Cloudy,
Fat of boiled
Urine,2ib. 12 oz.
1 1 ft. 6 lb.
Ditto,
ham, 1 1 oz.
Stool, IOOZ.
5 oz. 4 dr.
Ditto.
Bread, 2 lb.
Tea, 3 lb. 9 oz.
29.
Rain,
Fat of ham,
Urine, 2 lb.
11 ft. 61b.
Cloudy,
2 oz.
4 oz.
9 oz. 8 dr.
Ditto.
Bread, &c. as
Stool, 1 lb. 6 oz.
above.
8 dr.
30.
Cloudy,
Fat of ham,
Urine, 2 lb.
1 1 ft. j lb.
Mixed,
3 oz.
13 oz.
12 oz. 4 dr.
Cloudy.
Bread, &c, as
above.
1
31-'
Rainy, •
Fat of ham,
" "
Urine, 2 lb.
11ft. 5lb.
Ditto.
a^oz.
15 oz.
13 oz, 4 dr.
•
Cloudy,
Bread, &c. as
above.
X2
REMARKS.
( *5* )
REMARKS.
Jan. 28. The fat of bacon ham is much more greafy than that
of beef. I ate as much of the fat, quite pure, at breakfaft and
dinner, as was agreeable to my ftomach; and, though at fup-
per I was rather hungry, I took none, being apprehenfive of its
purging me. Some little time before dinner I had a ftool of a mo-
derate confidence, covered with a white frothy liquid. At bed-
time I was very hungry.
29. Having obferved that my urine ran off pretty copioufly, both
after breakfaft and after dinner, and being fomewhat hungry towards
nine o'clock, I intended to have ate half an ounce more of fat at
fupper, but was prevented by a fudden commotion in my bowels
which was followed by a loofe, frothy ftool, though without
any confiderable uneafinefs or griping, as was the cafe after eatinp-
butter j I was the whole day uncommonly dull and low-fpirited.,
and in the evening, before going to bed, made two pints of water.
30. May not the purgative quality of the fat be imputed, in a
great meafure, to its rancidity ?
31. I found no inconvenience from the encreafed quantity of fat
which I ate this morning at breakfaft. At bed-time I was fome-
what hungry, and had a loofe (tool, without any confidei*able uneali- .
nefs, although I was griped after it ; there were fome whitifh par-
ticles mixed with the /tool, and along with it alio lome ropy mu-
cus. Upon my prefent diet I was never thirfty, had hardly any
wind, and no defires.
EXPERIMENT
( i$7 )
EXPERIMENT XXII.
Diet, Bread, Lean of Bacon Ham, Infujion of Tea, wkb
Sugar.
Day of the
month.
Feb. i.
State of the
weather.
Mixed,
Serene,
Ditto.
1
Allowance of
food.
Lean of ham,
10 oz.
Bread, z lb.
Tea, j lb. 9 oz.
Difcharges by
urine and ftool.
Urine,2 lb. 4 oz.
Weight of the
body.
11 ft. 5lb.
1 3 oz..2 dr.
2.
Serene,
Cloudy,
Ditto.
Food, ditto.
Urine. 31b. 9 oz.
Stool, iooz.8 dr.
Ditto, 2 oz. 8 dr.
Ditto, 9 dr.
Ditto, 3 dr.
1 1 ft. 3 lb.
14 dr,
Cloudy,
Ditto,
Ditto,
Lean of ham,
g oz. 4 dr.
Bread, &c. as
above.
Urine, 2 lb.
9 oz.
Stool, 2 oz. 6 dr.
1 1 ft. 5 lb.
4 dr.
REMARKS.
Feb. 1. I was extremely thirfty after dinner, but was rather
hungry than thirfty after fupper. In the evening I pafTed fome
wind downwards,
2. Iawoko
( >J3 )
2. I awoke early in the morning with pain in my bowels, palTed
fome wind downwards, was obliged to get up to the chair, and
had a loofe ftool, of a yellow colour, and unequal confiftence.
I was very hungry for breakfaft, and immediately after it was
griped, and had a iecond loofe ftool, which was flimy and accom-
panied with violent (training ; the purging continued all day, at-
tended with great forenefs, pain in my bowels, and violent ftrain-
ing ; the ftools were chiefly flime or jelly, with fome feculent
matter and Mood j notwithftanding this indifpofition I was hungry
at bed-time.
3. I was pretty eafy during the night, and continued fo till
after dinner, when the uneafinefs in my bowels returned, and I
had a loofe flimy ftool, and paired a good deal of wind. My urine
was high-coloured. Was the purging owing to the falts in the
ham, to the firmnefs of its texture, or to its being fomewbat
rancid ?
EXPERIMENT
( 159 )
EXPERIMENT XXIII.
Diet. Bread, or Flour, with Honey, and Infufion of Tea or of
Rofemary.
Day of the
month.
Feb. 4.
State of the
weather.
Cloudy,
Ditto,
Mixed.
1
Allowance of
food.
Breakfaft,
Honey, 3 oz.
Bread and tea,
Dinner irregular.
Difcharges by
urine and ilool.
Urine,2lb.iooz.
1 foft llool, not
4; an oz.
Weight of the
body,
1 1 ft. 5 lb.
7 oz. 4 dr.
S>
Serene,
Mixed,
Rainy.
Honey, 8 oz.
Flour, 1 lb-8oz.
Water, 8 oz.
(made into a pud-
ding.)
Tea, without fu -
gar, 3 lb. 8 oz.
Urine,i lb. 15: oz,
Stool, 7 oz.
1 1 ft. 6 lb.
2 oz, 2 dr.
6.
Serene,
Ditto,
Ditto.
Honey, 8 oz.
Bread, 2 lb.
Weak infufion
of rofemary,
3 lb. 8 oz.
Urine, 4 lb.
10 oz.
Stool, 10 dr.
1 1 ft. 3 lb.
1 4 oz. 3 dr.
7'
Rainy,
Snow,
Mixed, very cold.
Honey, 1 2 oz.
Flour and water,
as above, (made
into a pudding.)
Infufion of rofe-
mary, 31b. 8 oz.
Urine. 1 lb. 15 oz.
Stool, 9 oz.
Ditto, 10 oz.8 dr.
1 1 ft. 5 lb.
9 dr.
8.
Serene, "i
Ditto, [.Froft.
Ditto, y.
Honey, 6 oz.
Bread, 2 lb.
Infufion, 3 lb.
8 oz.
Urine, 4 lb. 11 oz.
Stool, 6oz. 4 dr.
Ditto, 2 oz. 1 3 dr.
n ft. 1 lb
1 3 cz. 6 dr.
9-
Serene, *}
Ditto, > Froft.
Cloudy. )
No Honey,.
Bread, 2 lb.
Infufion, 3 lb.
8oz.
Urine, 1 lb. 3 oz.
11ft. 11 lb,
iooz. 8 dr.
EXPERIMENT
( 160 )
EXPERIMENT XXIII. continued.
Day of the
State of the
Allowance of
Difeharges by
Weight of the
month.
weather.
food.
urine and ftool.
body.
Feb. 10.
Rainy.
Honey(whichhad
Urine, j lb. 9 oz.
lift. 10 lb.
Cloudy,
been expofed to a
Stool, joz. 2 dr.
10 oz. 2 dr.
Ditto.
boiling heat)4 oz.
Bread and infu-
fion of rofemary,
as formerly.
ii.
Cloudy, 7
Virgin honey,
Urine, 2 lb. 1 oz.
1 1 ft. 4 lb.
Ditto, S. Mild.
4 oz.
Stool, 1 lb. 1 oz.
14 oz. 9 dr.
Ditto, J
Bread and infufion
as formerly.
12.
Cloudy, 7
Honey (heated in
Urine.z lb. 1 2 oz.
1 1 ft. 4 lb.
Ditto, £ Mild.
balneo Maria;)
7 oz. 2 dr.
Ditto. 3
40Z.
Bread and infu-
fion, as formerly,
*3«
Mixed, 7
Honey. 4 oz.
Urine, 2 lb.iooz.
1 1 ft. 4 lb.
Cloudy, [Mild
Flour, 1 lb. 8 oz.
11 oz. 9 dr.
i
Serene. ■*
Water, 1 2 oz.
(made into a pud-
ding, and ftewed)
for feveral hours. ,
Infufion, 3 lb.4'oz.
H.
Serene, 7 \r
Mixed, ( Ve,7
Serene. J mild'
Honey heated,
8 oz.
Urine, 41b. 13 oz.
•
1 1 ft. 1 1 lb.
150Z. 4 dr.
Bread, 2 lb.
Infufion, 3ID.80Z.
»5-
Cloud;. , 7
No Honey,
Urine, 2 lb. 6 oz.
1 1 ft. 1 1 lb.
Ditto, £ l'ogu
Bread, 20Z.
Stool, 1 lb. 6 oz.
8oz. 10 dr.
Ditto, J
Tnfufion of rofe-
Ditto.
1
n.ary, 2lb. 6 oz.
REMARKS.
( i6i )
REMARKS.
Feb. 4. I breakfafted on three ounces of honey with bread; a*
dinner I was irregular, and drank fome wine.
5. (Venus femel.) I had a fiool immediately after breakfaft,
of a proper confidence, but which contained fome pieces of plum
and currant-fldns, w;jich I had ate the preceding day. My honey
pudding, which had been fiewed for feveral hours, was fo firm
that I had fome difficulty in chewing it -y a pound of it was rather
too much for breakfaft, and, though I was very hungry at dinner,
I found even then a pound more than agreeable. In the after-
noon and evening I pafled fome wind downwards, at bed- time I was
extremely hungry. May we not reafonably fuppofe that food which
is difficult to chew is difficult alfo to digefl ? Is not bread of
more eafy folution in the (lomach than pudding, made with the
fame quantity of water. The pudding made with honey, befides
being tough, was, in other refpecis, far lefs pleafant than bread
and honey.
6. This day I varied the Experiment, to try whether the heat,,
©r the intimate combination of the honey with the flour, made
any fenfible alteration in its effects. I made a larger quantity of
urine, and which, of courfe, was much paler. Before dinner I
had a fmall flool ; after fupper I paffed fome wind, and felt fome
flight commotion in my bowels 5 at bed-time I was extremely
iwngry,
y 7. £1
( i6i )
7. In my pudding to-day, only eight ounces of honey were
mixed with the parte, four ounces were added afterwards. Im-
mediately after breakfafl, I had a ftool of a common confiller.ee,
and before fupper had a loofe one, but without being griped.
This evening I felt rather more commotion in my bowels than
on the preceding one. I was very hungry for every meal, and, at
going to-bed, extremely fo.
8. This morning, foon after getting up, I was a little griped,
and had a loofe flimy ftool of a moderate confidence. During
the day I had three more purging ftools, and was a good deal
griped, with confiderable uneafinefs in my bowels ; I had no
appetite for food and was liftlefs, drowfy, and uneafy all the
evening.
9. I was fomewhat uneafy in the night, and this morning
early I was obliged to get up to the chair, and had a loofe flimy
itool, about eight ounces in weight. Yeflerday my urine, after
fome time, became turbid, and depofited a brick-coloured fediment;
to-day it was high-coloured, and became turbid alio when cold.
As I was flill fomewhat uneafy in my bowels, I thought it pru-
dent to take no honey to-day; I omitted it alfo more readily,
imagining that by fo doing, I fhould be able to judge more ac-
curately of its effects. I had little wind in my ftomach during
this or the two preceding days, nor had I any acute pain, or
griping in my bowels, yet I was dull, and felt a general un-
eafinefs. To-day, after taking a walk, I was hungry for dinner,
and this morning I perceived, for the firft time, on the infide of
my cheek, a fmall, fmarting, afh-coloured ulcer, its edges very
red and fvvelled, but the gums and fkin have, as yet, no morbid
appearance.
10. (Venus
( i63 )
io. (Venus femel.) I had fome uneafinefs in my bowels in
the morning. Being defirous of afcertaining the effect of heat on
honey, what I ufed to-day was previoufly kept, for three or four
hou rs,in balneo Maria?.
ii. After breakfaft I had a ftool of the common confidence;
iu the evening had fome commotion in my bowels. The edges
•f the fore in my mouth were not fo much fwelled as the
day before, Was not the retention of urine on the 9th and
10th to be afcribed, rather to an mdifpofition occafioned by ufing
too great a quantity of honey, than to the honey itfelf ?
12. I was not very hungry either yefterday or to-day; now
and then I was a little griped ; in the evening my gums,
particularly on the infide, were hot and fomewhat fwelled, a be-
ginning fcorbutic fymptom ; at bed-time I was again a little griped,
and had a foft, or rather a loofe ftool.
13. Having found that heated honey, taken with bread, is
not more diuretic than common honey, I again made it into a
pudding, to try whether in this way it would not have the fame
diuretic quality as it had in the beginning of thefe Experiments.
My urine run off very fart, and I was extremely hungry at bed-
time; I had neither griping, wind, or inclination to ftool.
14. I was extremely hungry for breakfaft. I ate a larger
quantity of heated honey than I had ever done, to try if it
would prove diuretic, by encrealing the quantity,
Y2 Do
( 1 64 )
Do not the preceding Experiments mew, that heated honey,
though lefs purgative, is not much more diuretic than virgin-
honey ? and, as neither bread nor pudding have, of themfelves,
any diuretic quality, we are at a lofs to account for the remark-
able diuretic effect of honey pudding.
Upon the honey diet I had no defires, no wind upwards,
and little downwards; my fpirits were, as ufual, pretty goo^
and my body fufiiciently active.
EXPERIMENT
( i65 )
EXPERIMENT XXIV.
Diet. Bread, with ChejJAre Cheefe, and Infujion of Rofmary.
Day of the
State of the
Alloivance of
Djfcharges by
■ Weight of my
Month,
Weather
food.
{tool and urine.
body,
February 16.
Cloudy,
Chefhire Cheefe,
Urine,
11 ft. —
Ditto,
4 oz.
Stool,
50Z. 12 dr.
Ditto.
Bread, not quite
2 lb.
Infufion of rofe -
Ditto.
mary, 2 lb.
About 1 lb. of
<
mulled Port.
*7«
Rainy,
Bread, 2 lb.
Urine, 2 lb. 4 oz.
11ft. —
Cloudy,
Cheefe, 40Z.
Stool,
11 oz. 2 dr.
Ditto.
Infufion of rofe-
Ditto.
mary, 3 lb.
- >
Water, ilb.Soz.
18.
Mixed 1 tt .
ij . „ ( Hurn-
Kain & > _
Bread,
with infufion of
Urine, 1 lb.iooz.
)i ft. 131b.
5 oz. 10 dr. ■
c I canes.
Snow. J
rofemary, no
cheefe.
REMARKS.
On the evening of the 14th I was very well when I went to
bed, but awoke before day with confiderable uneaiinefs in my
boWels, and had feveral loofe ftools.
Jn
( 166 )
In the morning of the 15th I was chilly, fometimes with
fhivering, was liftlefs and uneafy, though the uneafmefs was chiefly
in my bowels ; I had not the fniallefl appetite for food, For
breakfaft I took about two ounces of bread, with a pint of in-
fuiion of rofemary, which, in about an hour after I had taken it,
run from me by flool without pain. I continued all day ex-
tremely uneafy, fighing and moaning. Owing to my feeblenefs,
I lay mofl of the time in bed, but without being fenfible of any
relief. In the evening, being thirfly, I drank another pint of in-
fufion of rofemary. In the afternoon, befides my other com-
plaints, a head-ach came on, which continued all night. Du-
ring the night I was refllefs, very uneafy in the lower part of
my belly, and had five or fix liquid flools, but did not make above
a few fpoonsful of urine.
16. Towards morning the head-ach went off, but I was ftill
uneafy in my belly, and had no appetite for food. My fkin re-
tained a natural appearance, and my gums, fo far from being af-
fected in the manner they had been by fugar, were univerfally
very pale, almoft white, and not in the leafl puffed up or pain-
ful. Immediately after breakfaft I had a fmall watery flool ; in
the forenoon had a good deal of uneafinefs in my bowels, at times
fome wind upwards. I was quite low and unfit for fludy; be-
fore dinner I had a fmall liquid flool. In the evening, being
ftill uneafy in my bowels, and with noife in them, I took fome
mulled Port wine, and found myfelf better after it.
Does not an excefs in fweets give a flill greater fhock to the
constitution than an excefs in fats ? Is there any other article
of food fo hurtful as either, taken immoderately ? Does it not
appear
( i«7 )
appear evident, that an excefs at the end of a courfe of diet, is
more hurtful than at the beginning of it ?
17. I had a little head-ach laft night when I went to bed,
was late in getting to ileep ; pretty early in the morning had a
foft ftool, ftill a little uneafinefs in my bowels, and not much ap-
petite. Before breakfaft had a fmall liquid ftool, after which I
was very uneafy in my bowels. I had, pretty frequently, wind
from my ftomach, with now and then pricking pains in my
bowels, and ineffectual attempts to go to ftool -, no appetite for
food, but was tbirfty. Urine high-coloured. At bed-time was
tolerably well. Is my prefent indiipofition owing in any meafure
to the change of weather ? I purpofed, after the honey-diet, to
have tried fome of the fweet fruits, but I found every thing
fweet fo difagreeable to me, that I rather chofe fomething ex-
tremely oppofite.
18. I flept pretty well, but, when I awoke in the morning,
I felt much forenefs in my bowels, as if they had been bruifed,
which made me figh and groan; this uneafinefs continued after
I got up, and I had little or no appetite for breakfaft.
The urine which I made yefterday was turbid. I felt univerfally
ill, and ©pprefTed, with great uneafinefs in my bowels, and fome-
times much noife in them. I pafled no wind downwards, but
feveral times upwards. I was dull, very lazy, often fighed and
moaned, and had no appetite for food. Four hours after rifing
this morning I breakfafted on bread and infufion of rofe-
mary, but had no appetite. Sufpecting that my prefent com-
plaints might poflibly arife, in part, from the cheefe, I
this day omitted it. In eating bread, I found the infide of
my
( 168 )
my mouth a little fore. There were two or three fmall pimples
alfo at the corner of my mouth, and about as many large ones
on my body. The uneaiinefs in my bowels, and univerfal dif-
trefs, encreafe when the hurricanes approach, and during their
continuance I cannot ftir, or even look up. Nothing palfes
through me, except fometimes a little wind upwards, or downwards*
and that without relief.
Here terminates Dr. Stark's 'Journal, with the afeBing
recital of his illnefs and fuferings, during the lajl day of hisr
life that be was capable of defcribing them. I'he fequel of this,
melancholy jlory, with the account of the fatal catajlrophe which
foon followed, I jhall defer until I have fni/Jied with his oth.cn-
Experiments*.
STATICAL
STATICAL EXPERIMENT,
O R,
OBSERVATIONS
Made on the Weight of the Body, with a View to determine how far
it is affefted, both in the Day and Night, by the Discharges of
Perfpiration and Urine, .
TH E daily food, during the time in which the following
obfervations were made, was always (the 3d and 1 6th of
December excepted) one pound eight ounces of flour, four pints of
water, twelve drachms of fait, fometimes with oil, of different
kinds as marked in the Table, fometimes without.
From the 5 th to the 23d of December inclufive, the food was
taken in equal portions, at two different times in the day ; but
both before and after this period, it was taken at three times.
The quantity ufed at breakfaft and dinner was nearly equal, and
double what was ufed at night.
As the body was weighed every hour during the day, the
wafte, or lofs of weight which it fufhuned, from the infenfible
perfpiration and urine, was every hour exadtly afcertained ; and
the quantity of nodturnal perfpiration was, in like manner, efta-
blifhed, by weighing the body at going to bed, and immedi-
ately after rifing in the morning: and, by weighing it again di-
rectly after making water, the quantity or weight of the noctur-
nal urine was alfo known.
Z EXPLANATION
( '7° )
EXPLANATION
Of the ABBREVIATIONS, employed in
The following T A B L E.
The Table is divided into columns, according to the day of the month. On one fide are
marked the hours after each meal, and dire&ly oppofite to them, the quantity of perfpiration,.
or of perfpiration and urine evacuated in each hour.
When two figures are joined by a crotchet, the oppofite number marks the lofs of weight atthe-
end of both hours.
The ftate of the atmofphereis marked by the letters f.c. r. f. m. (the initials of ferene, cloudy,
rainy, foggy, mixed,) placed immediately after the hour.
The letter w. placed immediately after a fingle hour, fignifies that I walked moderately in the
open air, during all or moll. of the time ; but when placed oppofite to a crotchet it only implies-,
that I walked part of the time.
b. ch. means fitting in my bed-chamber.
ex. ufing moderate exercife.in the houfe.
1. lying in bed.
fl. aflcep in my chair by the fire.
n. fitting quite naked by the fire.
b. buttoned op in my great coat.
d. at the further end of my dining-room, near the door.
Where there is no mark but what denotes the ftate of the atmofphere, it implies,, that during
that time I was at home, and nearly at reft.
( 17' )
STATICAL TABLE.
November 29. \ November 30. | December 1.
December 2.
6 oz. of fuet, made into
6oz. of fuet.
6 oz. fuet.
4 oz. of fuet.
a pudding, with flour.
Breakfaft.
After rifing.
In bed 8 hours, in
In 8 hours nocturnal
which time I perfpi-
perfpiration,
Hour Perfpiration
Hoar Perfpiration
red, 8 oz. 1 2 dr.
10 oz. 1 dr.
oz. dr.
oz. dr.
1
1 2 10
After rifing.
After rifing.
2 2 1
2 1 13
3 I r?
Hour Perfpiration
Hour Perfpiration
*]w. 4 9
Breakfaft.
1 3 2
oz. dr.
if. 28
oz. dr.
1 c. 2 II
Dinner.
*}w. 5 6
2 f. 1 13
2 c. 2 5
1 2 7
Breakfaft.
Breakfaft.
2 1 15
Dinner.
if.. i 13
1 m. 22
3 > I2
1 2 9
2 m. 20
2 f. w. x 6
4 * J4
2 1 14
3 f- » i3
3 r- 3 2
5 » 8
3 \v. 0 1 1
4 2 7
4 f . in
4 f. 1 rj
1
Q lb. I 2 I
Dinner.
Dinner.
Sapper.
1 f.w. 2 7
if. 1 13
1 112
2 f. 28
2 f. w. 1 14
2 3 2
3 f- 2 3
3 f. 2 10
1
3 1 10
4 f. 27
4 f . 21
4 1 2
Supper.
Supper.
if. 18
13 lb. 1 11 14
if. 12
2 f. 1 10
2 f. 1 12
3 f- 15
3 f. 16
4 f. 121
13 lb. 1 9 7
14 lb. 1 120
.,.._...,.. .....
Z 2
Decembe?
( *72 )
December 3.
No Food*.
4 oz. of fuet.
In 9 hours nocturnal In 8hours, 30 minutes,
perfpiration, nocturnal perfpiration.
10 oz. 4 dr.
After rifing.
Hour
c.
c.
c. 1.
c.
c. 1.
c.
c. 1.
9c
10 c. I.
11 c. n.
12 c.
j3 c. n.
14 c.
13
Perfpiration
oz. dr.
not obferved
3 4
1
o
z
o
2
o
2
O
I
I
I
I
J3
10
5
4
o
10
1
9
1 1
6
6
2
lb. 1
1
8 oz. 6 dr.
After rifing.
Hour
1 f.
Perfpiration
oz. dr
2 15
4 oz. of fuet.
6.
4 oz. of fuet.
In 8 hours, 30 minutes In 8 hours, 15 minutes
nocturnal perfpiration, nocturnal perfpiration,
8 oz. 14 dr. 9 oz. o dr.
Hour
After rifing.
Breakfaft.
c.
c.
c. w.
c.
c.
Dinner.
c.
c. w.
c.
c.
Supper.
Perfpiration
oz. dr.
3 2
2 3
2 1
1
o
1
Breakfaft,
'3
lb.
r. w.
r.
r. w.
r.
Dinner.
14
lb.
15
13
5
H
After rifing.
Hour Perfpiration
oz. dr
1 c.
2 c.
Breakfaft.
1 c. w. 3 6
2 c. 27
3 c. w. 3 3
4 c. 212
Dinner.
6
5
13
1
'3
lb.i
H
* I was induced to try the effect of long farting, partly with a view to diminifh the quantity
of urine fecreted in the night, which, from its copioufnefs, I found difficult to retain till the
morning. Ftom the 5th to the 8th hour after rifing, I was very hungry, I then loft my appetite,
became faint, weak, peevifh, and, laftly, fell afleep.
During 8 hours of the day, viz. from the 3d to the nth, I alternately fat by the fire in my di-
ning-room, or in my bed-chamber, where there was no fire. During the laft four hours, I alter-
nately fat naked, or with my clothes on in the fame place by the fire.
t On the 6th day, after dinner, I walked only in the beginning of the 5th hour, and towards
■*ie end of the 7th.
December
( l73 )
December 7.
8t.
9fc
10.
4 oz. of fuet.
4 oz, of fuet.
No oil.
No oil.
In 8 hours noclurnal
In 8 hours, 45 minutes
In 6 hours 15 minutes,
Noclurnal perfpiration
perfpiration,
noclurnal perfpiration,
noclurnal perfpiration,
not obferved.
7 oz. 1 3 dr.
8 oz. 10 dr.
6 oz.4 dr.
After rifing.
After rifing.
After rifing.
After rifing.
Hour Perfpiration
Hours Perfpiration
Hour Perfpiration
Hour Perfpiration
oz. dr.
oz
dr.
oz. dr.
oz. dr.
1 c 31
1 f 2
1 1
1 f 1 12
1 f I 11
2 m 1 iz
2 f 2
2 f 3 10
2 f 23
3 m 29
3<"
12
3 f w 26
4 f 2 3
3 m 17
Breakfaft.
Breakfaft.
c f w 17
Breakfaft.
1 { w 3 6
1 f 3
2
6 f 2 13
1 c ex 3 °
2 f 32
2 f w 2
6
2 c 22
3 f W 112
3 f
8
Breakfaft.
3 r ex 27
4f *3 *
4 f w 1
8
if 23
4 r 112
5 f 3
6
2 f i 12
5 r ex 25
Dinner.
3 C a 1
6 Hi
j}fW 5 8
Dinner.
j f b ch 1
?
Dinner.
Dinner.
3 f 2 9
2 f 2
1?
1 f d 1 10 \
1 18'
4 f 25
5 ' H
3 f b ch 0
4 f 2
12
»9
2 f 20
3 f d r 2
;}*
5 f b ch 0
6 2
4 f 24
c f d 014
4 1 10
5 * 9
12 lb. 1 15 0
4
6 f 23
14 lb. 1 13
1 1
14 lb I g c
r ; lb. 1 13 10
1
* The unufual encreafe in the quantity of the perfpiration, during the hour immediately pre-
ceding dinner on this and the following day, was, I believe, owing to my having fat nearer
the fire than I commonly do.
4 This day,' after dinner,- I alternately fat in my bed-room, where there was no fire, or in
my dining-room, where there was one.
I On the 9th and 10th, after getting up and weighing, I went to bed again, and lay for an
hour without going to fleep. On the 9th, I, for 6 hours after dinner, alternately fat near the"
door of my dining-room, at a confiderable diftance from the fire, or at a moderate diftance from
it; and on the 10th, for 6 hours after breakfaft, I alternately ufed moderate exercife, or fat ftill
in my room*.
December
( i74 )
December 1 1*.
No oil.
Nocturnal perfpiration
not obferved.
After rifing.
Hour
i c
2 C
Perfpiration
oz. dr
Brcakfaft.
i c
2 C
3 c
4 c
Dinner.
c w
c
i
2
3 c w
4 c
c r w
6 c
7 r w
8 r
12.
No oil.
In i hours, 20 minutes
nocturnal perfpiration,
7 oz. 5 dr.
After rifing.
Hour
1 f
2 f
Perfpiration
oz. dr.
'4
lb. 1 13 1
4
10
Breakfaft.
f w 2
f w 1
f 2
f W I
Dinner.
Perfp. Urine 1).
I f
2
2
2
2
0
3
1 1
4
5
6
1 1
6
8
7
5
14 lb.
1 12
4
-
1 lS
2 1
In 7 hours urine,
lb. i o 1
»3«
No oil.
In 7 hours, 15 minutes
nocturnal perfpiration,
6 oz. 1 5 dr.
Urine collected in the
night, 1 lb. 3 oz. 7 dr.
After rifing.
Perfp.
Hour oz. dr
1 f 1 16
2 c 3 3
Breakfaft.
1 c
2 c
3 f
4f
5 frw
6 f
Dinner.
1 f r w 1
2 c 1
3 m 1
6 J
m w 4 1 1
14 lb. 1 9 8
Or,
7 4
5
1 12
1 4
1 9
1 13
2 2
2 1
2
1 12
8 12
14.
4 oz. of fuet.
In 8 hours nocturnal
perfpiration,
7 oz. 8 dr.
Nocturnal urine,
1 lb. 9 oz. 1 2 dr.
After rifing.
Perfp.
Hour oz. dr
1 c 29
Breakfaft.
1 r
2 r
3 r
4 r
5 c
6 m
2
2
2
1
1
I 12
Dinner,
in w 2
2 c
3 m w
4
;
6
7
Ur.
3 '
1
o
0 1
i 8
1 S
1 11
1 1 1
I I2
1 1 1
1 '3
1 »3
> 13
3 3
2 6 14 14 lb. 1 io 4|i 7
* During the 5th hour after dinner, I walked without my great coat ; the reft of the time,
whilft walking, I had it on.
|| The quantity or weight of the urine fecreted each hour, was determined by weighing the
tody immediately before and after making water.
December
( 175 )
December 1 5.
16.
i7«
18.
1
4 oz. of frefh butter
The food of this day
4 oz. of frefh butter.
4 oz. of frefh butter.
mentioned below.
In 7 hours 45 minutes
In 7 hours nocturnal
In 7 hours nocturnal
'n 8 hours, 30 minutes
nocturnal perfpiration,
perfpiration,
perfpiration,
nocturnal perfpj
ration,
7 oz. 9 dr.
6 oz. 1 2 dr.
6 oz. 1 1 dr.
8 oz. 3 dr
#
Nocturnal urine,
Nocturnal urine,
Noctornal urine,
Nocturnal urine,
1 lb. 1 oz. 11 dr.
1 lb. 1 oz. 7 dr.
1 lb. 6oz.4dr.
I lb. 1 1 oz. 7 dr.
After rifing
After rifing.
After rifing.
After rifing.
Hour Perfp.
Ui
Hour Perfp.
Hour Perfp.
Hour Perfp.
oz. dr.
oz. dr.
Ui
oz. dr.
oz. dr.
1 c 211
2
8
1 c 26
2
8
if 13
1 2
1 c 38
6 8
2 c 21
1
lS
2 c 21
1
6
2 c 2 13
1 2
Breakfaft, .
Breakfaft.
Breakfaft.
Breakfaft.
1 c 17
0 13
1 c , 1 12
0
13
Suer, volks of
if 13
0 3
;}c 3 5
2 c in
1
1
eggs, of each 2
2 f 1 S
0 1 1
1 12
3 c » '5
1
7
oz. water, 2pmts
3 f ii +
1 5
4 r 29
1 10
4 m 115
1
1 :
1 m 111
8
5
4 28
1 1
5 r 27
2 9
5 c 19
6 c 1 14
1
7
2 f 1 10
2
9
5 f w 3 1
1 15
1
12
3 f 1 10
2
1 1
Dinner.
4 m 0 1 j
1
14
Dinner.
1 c w 112
2 +
Dinner.
5 m 10
1
10
j}fl 3 10
2 1
2 112
1 12
1 c w 115
1
»3
3 1 9
0 IC
2 1 7
1
0
3 1 8
0 10
4 r w 110
0 14
3 2 '
4 m w 1 4
2
0
Dinner.
4 f w 2 5
1 7
5 112
1 1
2
2
Figs, 1 lb.
5 1 iJ
1 14
6 , 5
0 14
Water, 2 pints.
6 1 4
111*7 1 7
2 0
12 lb. 1 6 3
} 11
1
1 m 212
2
1
1
2 f 115
3 f w 2 2
4f 1 14
2
A
1 3 lb. 1 0 1
0 [f ? U lb. I 8 n
1 6. 10
*2
2
4
c
5 1 14
3
6
6 1 9
6
»3
13 lb. 1 7 4
2 7
13
On. the irfh I had tvroloofe (tools, and one on the 16th, immediately after breakfaft.
December.
( '76 )
December i
9-
20.
es
21.
22.
4 oz. of frefh butter.
4 oz. of frelh butter
4 oz. of oil of marrov
4. oz. of oil of marrow.
In 7 hours 15 minutes
In 8 hours, 30 minut
In 8 hours 10 minut
In 8 hours, 1 c minutes
nocturnal perfpi
ration,
nocturnal perfpi
ration,
nocturnal perfpiration,
nocturnal perfpiration,
7 oz. 8 dr
8 oz. 3 di
8oz.
8 oz. 5 dr.
Nocturnal urine,
Nocturnal urine,
Nocturnal urine,
Nocturnal urine,
1 lb. 2 oz
1 lb. 2 oz.
7 dr.
1 lb. 8 oz. 1
4. dr.
1 lb. 6 oz. 8 dr.
After rifing.
After rifing.
After rifing.
After rifing.
Hour Perfp.
Hour Perfp.
Hour Perfp.
Hour Perfp
oz. dr.
Ur.
oz. dr.
Ur.
oz dr.
Ur.
oz. dr.
Ur.
if 28
2 7
1 c 35
2
5
1 c 3 3
2
6
if 24
2 0
Breafaft.
Breakfaft.
Breakfaft.
Breakfaft.
if 21
2 111
1 3
0 15
2}c 3 10
0
■5
l\c 414
2
6
if in
2 f 112
1 1
0 15
3 c 1 13
1 0
3 m 18
1
'3
3 r w r 10
1
8
3 f 15
1 1
4 c 1 13
1 0
4m w 3 3
4 c 26
1
4
4f 1 9
1 2
5 m w 3 4
2 8
5 m 1 14
2
2
5 c 21
1
6
Jf 1 7
'1 6
6 m 24
2 3
6 1 14
2
1
6
Dinner.
I 7 f w 2 5
2 14
Dinner.
Dinner.
1 c w 2 8
1
6 1 24
1 14
1 1 12
1 0
1 1 n
1
5
2 26
1
4 9 2 3
t 6
2 1 6
1 0
z 1 8
1
1 a
3 « U
1
12
10 f w 0 10
1 9
3 c w 1 6
1 0
37
4 f w 2 1
1
8
11 112
0 11
4 > '4
0 14
4 Vf w 6 7
6
I
5 * 8
1
5
5 1 7
6 1 8
1 0
1 1
O
6 1 8
7 * 7
1
2
'4
0
Supper.
1 1 14
0 12
1 — —
12 lb. 1 g 0
4
1 1
2 1 7
0 10
13 lb. i 8 11
1 1 4
13 lb. i 98
1 4
1
~~ • 5
'3 Ib.i 7 7
*I had two loofe ftools on the 19th.
December
( l77 )
December 23.
24.
2$.
26.
6 oz. of oil of marrow. 6 02. of oil of marrow. 6 oz. of oil of marrow
In 8 hours nocturnal
perfpiration,
8 oz. 9 dr.
Nocturnal urine,
14 oz, 11 dr.
After rifing.
Hour Perfp.
oz. dr.
1 r 32
Breakfaft.
1 r
2 c
3 m
4f
5 m w
6 m
7 f w
9
io m w
11 fl
Supper.
1 1 11
2 1 3
14 lb. 1 9 3 1 5 10
Ur.
oz. dr.
1 10
o 11
o 13
In 8 hours, 30 minutes
nocturnal perfpiration,
10 oz. o dr.
Nocturnal urine,
1 5 oz. 12 dr.
After rifing.
Hour Perfp
oz. dr.
if 3 13
Breakfaft.
1 f
2{
4 m w
j f w
Dinner.
1 b
2
5 f \f
6
1 10
1 9
1
1 10
2
1 13
lb. 1
Ur.
oz. dr
1 S
1
1 6
1 3
2 8
3 12
1 8
2 O
i 8
I 12
I 2
In 8 hours nocturnal
perfpiration,
9 oz. 4 dr.
Nocturnal urine,
i lb. 9 oz. 10 dr.
After rifing,
Hour Perfp.
oz. dr
1 r 215
Breakfaft.
1 r
2 r
3 r
4c
Sc
Dinner.
1 c w 2
2 r w 2
3 c w 2
4 2
Supper.
1 fl 1
2
3
4.
'5
9
13
7
5
12 1
J3
13 Ib.i 10 14 1 3 14
Ur.
oz. dr
2 3
i 11
1 6
1 3
1 10
1 7
2
2
1
1 10
1 2
1 14
In 7 hours jc minutes
noctuma' perfpiratkttij
8 oz. 2 dr.
Nocturnal urine,
1 lb. 5 oz. 8 dr.
After rifing.
Hour Perfp.
Ur.
1 C*
oz- dr..oz. dr.
2 14 2 12
* Having this day been very much indifpofed, I was obliged, atprefent, to difcontinue my
obfervations.
A *
Several
( 178 )
By adding together the particular numbers contained in this Table it appears,
'That in 355 hours, during the day-time, the perfpiration was, 698 oz. 7 dr. And
That in 1 go hours 15 minutes, during the night-time, it was, - 196 oz. 14 dr.
And by adding together the particular numbers, in that part of the Table fubfequent to the I2tk
of December it appears,
That in 169 hours, during the day-time, the perfpiration was, - 324. oz. 2 dr.
The urine was, - - 9 300 oz. 6 dr.
That in 109 hours 40 minutes, during the night, the perfpiration was, m oz. 9 dr.
The urine was, - - - 297 oz. 6 dr.
And hence, by a (hort calculation it will be found, that the hourly wafte of my body was
neaily equal, both day and night, being about 3 oz. 10 or 1 1 dr.
The influence of the food upon the perfpiration and urine may, in fome meafure, (though I
own imperfectly) be judged of, from the following Table.
Diet
( *79 )
No food
No flour
No oil
No oil
4 oz. marrow
4 oz. butter
4 oz. fuet
4 oz. fuet
6 oz. marrow
6 oz . fuet
Hours.
*3
l3
71
21
26
63
80
14
39
49
Perfpiration.
Urine.
oz.
l9
dr.
oz.
dr.
23
137
4
12
39
J3
5°-
J5
48
37
6
121
160
6
14
95
6
23
65
77
'3
5
99
6
Nightt. ]
Hours
. Min.
8
13
7
22
35
J5
15
16
Mr
39
25
47
30
7
45
24
25
Perfpiration.
oz. dr.
8 6
6 11
21 12
16 14
38 10
48. 3.
27 6
29 1
Urine.
oz dr.
45 3
31 3
106 3
23 "
4 14
■ * That is, whilft out of bed,.
4 That is, whilft in bed.
A 32
A Con-
( I to )
A Continuation of the STATICAL TABLE.
February 5.
Heated honey, 8 oz.
Breakfaft.
Hour Perfp.
after, oz. dr.
1 lfw
2 J m
3mf 3
4mf 2
5 12
Ur.
oz. dr.
to 9
7 10
5 6
Dinner.
1 c f 1 14
2 c w 2 o
3 c f 3 12
7 6
10 10
5 4
6.
Honey, 8 oz.
Dinner.
Hour
after.
1 f
zi
11'
Perfp,
oz. dr.
2 3
.2 4
supper.
I w 2
2f 2
3f *
Ur.
oz. dr.
1 10
1
1 14
« 9
i 6
Heated honey, 1 2 oz.
Breakfaft.
Hour
after.
2 f
3 C
4-f
Perfp.
oz. dr
3 o
2 o
Dinner.
1 f 2
.ht6
Ur.
oz. dr,
2 10
5 9
7
7 10
1 o 4
Honey, 6 oz.
Breakfaft.
Hour
after.
7 f
2 f
3f
4f
Perfp.
oz. dr.
2 6
2 o
1 J5
1 l5
Dinner.
♦J
10 14
Supper.
Ur.
oz. dr.
1
1 1
1 o
o 15
4 15
* Walked all the time till in a breathing fvveat.
+ Walked brifkly all the time in a cold wind.
■J Walked about half the time.
February
( i8i )
February 9.
No Honey.
Breakfaft.
Hour Perfp,
after. oz. dr,
Hf4
4 f w 3
2 14
Dinner.
1 f w
2cf
3 °
2 14
Supper.
if 22
Ur.
oz. dr.
0 14
2 1
1 4
o 14
10.
ir.
Heated honey, 4 oz.
Breakfaft.
Hour
after.
Perfp
oz. dr.
1 c f+ 4
2 c f 2
3f 1
4 c w 2
Dinne
3^
3 j
3
Ur.
oz. dr.
j 11
» 13
1 10
1 12
3 12
4 8
Hour
after.
«>
Honey, 4 oz.
Breakfaft.
Perfp.
oz. dr.
1 c f 210
2 c f 20
3 c w 1 4
Dinner.
1 c f
2 c w
3<"
Feb. 12.
Heated honey
40Z.
Breakfaft.
1 c f 213
2 c,\w 1 15
3 cf 2 9
Ur.
oz. dr.
2 4
1 14
2 4
2 3
6 2
3 7
2 2
2 8
2 7
Dinner.
Hour
after.
Perfp
oz. dr.
cf 29
Feb. 16.
Unwell.
Supper, mulled
Port wine:}; and
bread.
1 f
2 f
1 13
1 14
Head-ach.
Feb. 18.
After rifing.
3 mf 2
4 m f 113
Ur
oz. dr
J 10
1 12
2 o
1 2
o 14
* Sitting by the fire, or Handing in my bed-room.
T Sitting by the fire, excepting for a little time, in my bed-room, whilft I bathed my feet.
% My urine was increafed in quantity after drinking the Port wine.
It
( *32 )
N. B. It mould be remarked that the perfpiration, during the night-
time, and in the morning, before breakfaft, is influenced by the
food taken the preceding day, and therefore, ftrictly fpeaking, be-
longs to it, though their place in the Table mull, neceflarily, fland
as it does.
Several other remarks might be made on the Table, but they
will probably occur to the reader himfelf from the perufal of
it. I mall therefore only add, that although I have been ex-
tremely careful to avoid miflakes, yet I am ready to confers ,.
that wherever any uncommon encreafe or decreafe in the weight
of the body is obferved, it is more probable that I mould have
been miftaken, than that any thing uncommon mould have hap-
pened. I hare likewife to beg of the Reader to remember, that
thefe Obfervations were made, not fo much in hopes of deter-
mining any thing on this fubject, as of difcovering how the
land lay, and of enabling me to undertake] ibme more accurate
and decifive Experiments.
AN
A N
A C CO U N T
O F
Dr. STARK'slaftlLLNESSandDEAT H,
B Y
Sir JOHN PRINGLE, or by Dr. SAUNDERS, moft probably
the former*.
£$uis tali a fando
temperet a lacrymis P
DR. STARK died in the twenty-ninth year of his age. He was
of a fair complexion, tall, of a thin make, and healthful.
For feveral months before his death he had been employed in
making experiments upon himfelf, of the effects of different kinds
of food ; among the laffc was that of honey and flour made into
a pudding, upon which he had lived feveral days ; . and which feemed
to
* For this account I am indebted to Dr. Garthjhore, who tranjcribed it fame years ago
from the original copy, in the poffejjion of Dr. Huck Saunders.
( «84 )
to be extremely diuretic at firft*, as he made confiderably ' more
water than the liquor he drank. At lad it brought on a di-
arrhoea, for which he ate Chefhire cheefe, to the quantity of a
quarter of a pound, without any other food, and that feemed to
bind his body fo much that he had not been at flool for five
days-f*. When he was taken ill, on Sunday, the 1 8 th of Febru-
ary, 1770, he fent for Mr. Hewfon to bleed him, when he com-
plained of his head and in his belly, The blood was fomewhat
fizy. He had ufed fome opening medicines without effect, until
the 20th, that he took the OL Ricini, which procured five or fix
motions. On the morning of the 20th, he complained of an
opprefiion and ficknefs at his flomach, and he had fpit fome blood
in the night ; his pulfe was very quick, and he had other feverifh
fymptoms. He had no fleep for two nights, nor did he fhut
his eyes afterwards. Ordered tartar, emetic, gr. v. fal. rupell. 1 £
to be diffolved in a pint and a half of water, and of this, a
coffee-cup full every ten minutes, till it had a fenfible operation.
This was directed, upon the fuppofition that he had fome load
in his flomach and bowels, which was to be relieved by vomiting
and purging. He took three cupfulls, in all, of the medicine,
vomited thrice, and had {even loofe flools, but complained of great
ficknefs
* The diurifm lis afcribed to the boiling of honey, not having obferved that quality of
it when ufed iri its natural frate.
f- That he had eaten nothing but Chefhire Cheefe is not certain, it was at leaft two
days, one of the Gentlemen who attended him thinks more.
ft appears from Dr. Stark's own Journal, that the two preceding remarks are not perfefily
correcl.
( *85 )
ficknefs and lownefs after them. The next day, (21ft) he was
extremely low, had the anxietas pracordiorum in a great degree, reft-
leflhefs, flufliings in his cheeks, and complained much of a great flow
of fweet faliva in his mouth, which made him fick. The loofe-
nefs ftill continued. The following mixture was directed, ty
julep, e creta. I vii*>tin<3:. cinnamon. I fi> tinct. thebaic, gutt. x. m
dentur coch. iv. port alternas fedes liquidas. Of this he took one
dofe, and had no ftool after it. At this time he feemed much
worfe, he fpoke flow and low, and feemed with difficulty to recol-
lect:, or pronounce the word he wanted to utter.
During the night he was very feverifh, and fo delirious as to
attempt getting out of bed. The purging returned, and the ftools
were bloody and involuntary. He fometimes coughed and brought
up fome mucus, tinged with blood. A blifter, which had been
applied the night before, rofe well, but without any other effect.
A decoction of the bark and camomile-flowers, with fome Port-
wine, was thrice injected as a cly flier, which flopped his purging.
He continued to grow worfe, and died on Friday, the 23d,
Here follows Mr. Hewfons Account of the Illnefs and Infpeftlon
of the Body ; which Is added, as he was more with the Patient than
any of the Phyjicians who attended him.
On Sunday, the 18th of February, Dr. Stark fent to defire
me to bleed him ; I went at nine, and found him going to take
B b a clyfler.
( i86 )
a clyfter. He told me he had pain in the lower part of his
belly, that he had not made water in any quantity, nor had had
a ftool for three or four days -, this he attributed to a change in
his diet, viz: from a pudding, made of honey and flour, to cheefe,
of which I underflood he had eaten to the quantity of three or
four pounds, without having had any evacuation fmce he began
it, and this,, he told me was the opposite effect to that of honey,
for, whilft living on the pudding of flour and honey, he had
made more urine than he had drank water, which was all his
drink. Agreeable to his defire I took away nine ounces of blood,
which was received into four cups ; the two firft had an in-
flammatory cruft. The blood, at five o'clock, P. M. had very
little ferum, which I afcribed to its having flood in a cool place,
as the coagulum felt very firm, and as one cup, which was re-
moved into a warm room, had more ferum feparated the day fol-
lowing. Soon after the bleeding he took half an ounce of caftor
oil. In the afternoon he thought himfelf rather better, having
made water, and difcharged fome faxes, which he told me were
extremely offenfive. Upon enquiring whether he had been fenfible
of any enlargement of his bladder, he anfwered in the negative,
and obferved that obstructions there had not been total, for that
he had frequently made a fpoonful of water, and could, at any
time, difcharge a fmall quantity. He drank, during the day,
plentifully of water-gruel, with a little juice of orange in it.
On Wednefday morning, J found that he had been very reft-
lefs, hot, feverifh and thirfty, throughout the preceding night.
He faid that he had fpit blood, and complained of a pain in his
head. His face was remarkably florid, he feemed much opprefTed,
and fetched his breath every now and then with a moan. His
Qua
( «87 )
{kin. was very hot, his pulfe feemed to require another bleeding*
which he defired me to perform, but hearing that he had fent for
a Phyiician, another medical friend, I defired he would defer the
operation till after his viiit. I returned at twelve, and understood
that he had been defired to repeat his caftor oil, but not to bleed.
Upon examining his pulfe, I was furprized to find it fo much
altered in fo fhort a time, for it was remarkably foft, and it was
upon this change it was thought improper to open a vein. I law
him again at five o'clock in the afternoon, and found him much
oppreffed ; he moaned frequently, faid his ftomach loathed every
kind of watery liquor, complained of a violent pain in his fore-
head, was very low-fpirited, and told me he apprehended he mould
not outlive the night. That evening he was diredred to ufe the
following medicine, tart, emetic, gr. v. fal rupell I c difiblved in a
pint and half of water, of this he took, at intervals, about a third
part by cupfulls, till it operated. I faw him about an hour after-
wards, and he thought himfelf much relieved, though nothing had
come up from his ftomach, but the water he had drank and a little
mucus.
On Wednefday I found him very low, and conftantly {pitting.
He told me his faliva was fweet, and fuppofed that his purging
was owing to his fwallowing it in his fleep, for that when he fpit it
out he feemed to purge lefs. The pain in his belly, he faid,
feemed not fo low down as it had been, but added, that the pain
of his head was intolerable. He took, during the day, ibme chalk
julep, with two or three drops of laudanum, after every ftool.
In the evening he told me he was afraid to go to fleep, left he mould
•fwallow his faliva.
B b 2 On
( i.U )
On Thurfday-morning I underftood he had been delirious in the-
night, and had got out of bed in fpite of his nurfe, but had
immediately tumbled down on the floor. When I faw him he-
muttered his words fo that I could not underftand him, but
feemed fenfible of what I faid to him, and gave me his hand to
feel his pulfe. At two in the afternoon I found him evidently
worfe, for he was then infenfible, and his ftools were frequent
and involuntary, and, as the nurfe expreffed it, nothing but dis-
coloured water. He was bliftered, took glyfters of a decoction
of the bark, and ufed the julepum vitas of Bates for a cordial,
but from this time he grew worfe and worfe, and died next day
at four in the afternoon.
The body was examined by Mr. Hunter and myfelf, on Sunday,
at one o'clock. Upon opening the abdomen t wo or three ounces
of water were found in the pelvis. The bladder contained about
fix ounces of urine, of a natural colour. The fmall interlines ap-
peared very red and inflamed at particular parts, which, upon
opening into their cavities, was found to be the glandular peyeri-
anae enlarged. One clufter of thefe feemed ulcerated. Some of
the glandular folarias were of the fize of a fplit pea. The mefen-
teric glands were likewife enlarged, and, when cut into, were
found to be remarkably foft and tender. The ftomach, near its
upper orifice, internally, had the veflels of its villous coat tinged
with blood which burft* on a very flight preflure. The liver
feemed rather fmall. The fpleen rather larger than common, but
had no morbid appearance. The kidnies had their veins fuller of
blood than ufual, but the ureters and pelvis were of a natural
iize.
* The expreflion is broke dnvrr, in the original.
( i89 )
fize. The larger inteftines feemed quite found. In the thorax
there was found more water than even in people who die a violent
death, even after lying two days before diffection. The fame
was obferved of the, pericardium. The lungs had feveral black
fpots in different parts of their fubftance, owing to extravafated
blood. The heart feemed flaccid, and had no coagulum in it,
the blood being fluid ; however, one or two tranfparent coagula
were afterwards found in the veffels of the brain, but they were
very foft.
The dura mater had no morbid appearance j but the veffels
of the pia mater had more moiffure in the cellular membrane,
contiguous to them, than is natural. The ventricles contained
each about a tea-fpoonfull of water, and that in the left was of
a bright yellow colour. The pineal gland had feveral earthy par-
ticles in it. The other parts of the brain had no preternatural
aopearance.
'This was Mr. Hewson's written Account of the DiJJecJion.
Esata
Mr. Hunter gave the Phyjician the following Account of the
Appearance fome days afterwards, from his Memory* •
The brain had no morbid appearance, except that in the left
ventricle ; the ferum, which was not more than ufual in quantity,
had a flight bloody cart. The fubftance of the brain was of a
natural
( 190 )
natural firmnefs. In the thorax the lungs had a flight adhefion
to one fide, and there were macula?, fome of them as broad
as a milling, all over the furface of that organ ; owing to an ex-
travafation of blood in the cellular membrane, and under the com-
mon membrane of the lungs. In the fubftance of the lungs the
cellular membrane contained a good deal of extra vafated blood.
In the cavity of the thorax there was more than the natural
quantity of ferum. The heart was found, but upon opening it
and the great blood- vefTels, the blood was found in a refolved
flate, that is, about the confidence of iyrup without any polypus
concretion or coagulation. The liver was found. The gall-blad-
der was half full of bile, and of a natural colour. Nothing ex-
traordinary was contained in the ftomach and iuteflines. There
were no marks of inflammation on the ftomach, but there were
on the inteftines, efpecially towards the lower end of the ileum,
where the peyerian glands were found enlarged beyond their na-
tural fize, in fo much that they could be felt with the fingers
on the outride of the gut. There was no extravafated blood in
any part of the tube.
Mr. Hunter took notice in this fubject, of the beginning diilblution
of the internal coats, near the great end of the ftomach, but which he
accounted no morbid appearance, as it had been obferved on other
occafions.
After giving the above account Mr. Hunter added, that he had for-
got to mention the difeafed appearance he had obferved in the mefen-
terick glands. They were larger than common, and when cut into
were obferved to be much paler than natural, and their fubftance to be
fo foft as to appear like a pulp.
F I N I S.
N
D
E
X.
Page
A I R Veficles, State of - 28
Aneurifm of the Pulmonary Artery,
opening into a Vomica - - 31
Aorta, its Canal almoft fhut up by the Se-
milunar Valves 19
Afthma — See difficult Breathing.
B
Bacon (Lord) the Diftin&ion which he
made between ufeful and curious
Knowledge - - 90
Bark, its EffecT: in a copious Difcharge of
putrid Saliva - - 65
Blood, Extravafation of the red Part of
this Fluid 50
Blood-veflels, State of the large ones 28
Brain, a Cafe in which there was no mor-
bid Appearance in this Vifcus, after an
Apoplexy - - - 73
Cellular Subftance, Blacknefs of - 4
-————-«—— State of 3 28
Page
Colon, Irruption of Matter collected near
the right Hypochondrium into this In-
terline - g 8
Coftivenefs, the Symptoms that almoft
conftantly attend it - - 15
feveral of the Caufes that oc-
cafion it - ibid.
Cough, the different Kinds defcribed 38
without Expectoration ; or with
Expectoration of Mucus only - ibid.
■ with Expectoration of thick
Matter 39
■ with Blood fpit up in fmall Quan-
tities --___ 4.0
■ with Blood flowing from the
Mouth by Fits - - 41
D
Diet, general Obfervations on - 89
— — Facts relative to 92
— — Remarks on ; fee the Courfe of Ex-
periments the Author made on himfelf
beginning at 96
Difficult Breathing, its Symptoms - 43
Cc
INDEX.
Page
Difficult Breathing, an Inftance of its be-
ing relieved, upon the Appearance of
foft Tumors externally - 44.
1 a Cafe in which it
was immediately relieved, by the fpon-
taneous Difcharge of Matter from the
Side 45
Digeftion, Obfcrvations on - 94
Direction of morbid Bodies, the Advan-
tages that may be derived from it 85
Dura Mater, Suppuration of Part of this
Membrane 70
Page
this Difeafe, what Remedies they feem
to indicate - - 16
Ileum, Erofion of its Glands - 7
Interlines, Inflammation of the fmaller
ones, with EfFulion of Blood - 2
■ -«— Erofions of the internal and
neighbouring Coats of the larger ones 4
■ the glandular Follicles of the
great ones much enlarged, and filled
with a glutinous Subflance - 5
■ — numerous Conftiiclions of 9
Fever, with red or purple Spots on the
Skin - 62
Fluids, an uncommon Cafe of their Pu-
trefaction 53
Food, Experiments to determine how
long it is ufually retained in the Body 97
G
Gall-duel, the common, fhut up by a
Gall-ftone ; and opening of the hepa-
tick-duct into the Duodenum - 12
Liver, Hardnefs of, with Thinnefs,Tranf-
parency, and Difcoloration of the Bile 10
■ Abfcefs of - - - 11
■ ■ Hydatides in - - n
« whitifh Granules, or Tubercles in 12
Lungs, Ulceration of
22
Difeafe
■■■ ■ " Symptoms of this
ibid.
———————— Appearances on Dif-
feftion 25
their Veficles filled with extrava-
fated Blood 32
Lymph lodged between the Dura and Pia
Mater 68
Jaundice, the Symptoms by which it is
accompanied - - 16
»■■ the fpontaneous Vomiting and
Purging which frequently intervene in
M
Mercury, its Effect, in an obftinate Swell-
ing of the Limbs 64
Morbid
INDEX.
Page
MorbiJ AfFeclion, Degrees of, in Difeafes
of the Lungs - - - - 29
Motion, Lofs of, together with that of
Feeling - 77
Lofs of, with Relaxation of the
Parts ----- 79
Lofs of, with Contraction of the
Parts - - - - - 80
Defcription of that which is con-
usant and involuntary - - 82
Mufcles, deep red Blotches and partial
Suppuration in feveral, in Confequence
of a Wound - - 74
R
Page
Recovery, remarkable Inftance of, from
a violent Spitting of Blood - 42
Re<5tum, Stricture in - - 7
Remedies, Obfervations on their Effects
in the Cure of Difeafes of the Stomach 17
■ Cheft 47
a general Account of their Ef-
fects in the Cure of Difeafes of the Flu-
ids - 64
N . Obfervations on their Effects
in Difeafes of the Head, &c. -
Palpitation, Fits of, Symptoms of a Cafe
in which they terminated fatally ; with
Appearances on Diffection 19
Pericardium, Cafe of its Adhefion to the
Heart 20
■ enlarged, containing eight
Ounces of Blood, and adhering partially,
by fatty Papillae, to the Heart - 21
Pia Mater, its Veins apparently enlarged 72
Pleura, Inflammation of, and Effufion of
Blood in the intercoftal Mufcles - 36
Pleurifies, Symptoms of - - 46
Pulmonary Confumption. See Lungs.
Purging, the ufual Symptoms which ac-
company it - - 14
, Cafes of, divided into two Spe-
cies, the (limy and gelatinous ibid.
Putrefaction and Extravafation, united in
the fame Subject - - 55
Saliva, Experiment to determine the
Quantity fecreted withinacertain Space 99
Serum, or thinner Part of the Blood, Ex-
travafation of' 49
— — — coloured Extravafation of - 51
Stomach, Cancer in - 1
Surfaces, Suppuration of the contiguous
ones of the Diaphragm and Liver - 37
Swelling, with Fluctuation of the Belly 59
■ ■ » general external one, retain-
taining the Impreflion of the Finger 60
general external one, with
Swelling of the Belly - ibid.
a fluctuating one on the Loins 61
Thorax, in three Cafes of Confumption
found
INDEX.
Page
found on DifTeclion to be filled with
Lymph - - - 35
Trachea, Obfervations on - 29
Tubercles in the cellular Subftance of the
Lungs, Defcription of them - 26
V
Vomicae, an Account of - 27
Vomiting of Blood, mixed with the Food
Page
or Liquors of the Stomach, the ufual
Symptoms which accompany it j?
w
Weight of the Body, Obfervations made
with a View to determine how far it is
afFefted, both in the Day and Night, by
the Dilcharges of Perfpiration and
Urine - - 168
EXPLICATION
/'/. /
m
a-
S**6*
I^h
t
,.- ' s
EXPLICATION
OF THE
FIGURE S;
FIGURE I. PLATE I.
Reprefents a portion of the higher part of the colon, taken out of the body of the mars,
(Parti. Ch. i. § 3. p. 4.) and inverted.
a, A broad erofion of the internal coat.
b, &c. Smaller erofions of the fame coat.
c, &c. Small black fpots fhining through that coat.
FIGURE II. PLATE II.
Reprefents the internal furface of the return, and that of the adjoining part of the colon,
taken out of the body of the woman, (Parti. Ch. 1. § 4. p. 5.) and cut open*
A B. The circulus albus, and the boundary between.
C. Thefkin, and
D. The internal coat.
Above the circle appear the finus furfum cavi, defcribed by Haller (prim. lin. dccxlii.)
A great portion of the lower part of the re£lum, being quite found, is folded up.
a a. Hemifpheres filled with a gelatinous fubftance.
b. &c. Veficles of the internal coat, out of which the gelatinous fubftance having
been exprefled, blown up with air, and having one, two or three
openings, intofome of which a hog's brittle is introduced.
c. Openings of veficles not blown up.
d. Large irregular openings in the internal coat*
e e. Black fpots appearing through that coat.
f. A warty excrefcence.
FIGURE III. PLATE II.
Reprefents the internal furface of the middle portion of the colon, taken out of the fame
body, and cut open.
A. The middle point of the large inteftines*
B. The
EXPLICATION of the FIGURES*
B. The fupcrior extremity of this portion.
C. The inferior extremity of the fame.
D. Two lymphatic glands.
a a, &c. Irregular eminences of the internal furface, which, towards the upper
extremity were placed in two parallel lines, between which was a very
long livid depreffion.
b b. Hemifpheres filled with a gelatinous fubftance, each having a pellucid
middle point, at which, in one of the hemifpheres, a hog's brittle is
made to pafs a little way.
c, &c. Veficles, emptied of the gelatinous fubftance they had contained, blown
up, having each two openings, through which a hog's briftle is made
to pafs.
d, The orifices of veficles not blown up.
e, &c. Irregular erofions of the internal coat, and fometimes of the cellular
fubftance.
FIGURE IV. PLATE II.
Reprcfents the internal furface of a portion of the lower part of the rectum, taken out of
the body of the man (Part I. Ch. I. § 4. p. 5.)
In the middle part of the figure is reprcfented a large hemifphere, which, before
the portion of inteftine had been put into fpirits, was much fuller than it here
appears to be, and it was in fome degree tranfparent.
FIGURE V. PLATE I.
Reprefents the internal furface of the adjoining portions of the ileum and of the colon,
taken out of the body of the woman (Part I. Ch. 1. §4. p. 5.) and cut open.
A. The Appendix vermiformis.
A B. The lower portion of the ileum, on which appear numerous roundifh
eminences, becoming gradually fmalhr towards the higher part, where
they almoft difappear.
A C; The higher portion of the colon;
D. The valve of the colon cut open, j
* a, &c. Large veficles with one or more orifices.
b. Two irregular openings in the internal coat, probably the bafes of
veficles j one of them is a little raifed up by a briftle.
c. Two large erofions.
FIGURE
Hi?. 3.
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V xi'":- dP^JfT
EXPLICATION or the FIGURES.
FIGURE VI. PLATE I.
Reprefents the internal furface of a fmall portion of the lower part of the colon, taken
out of the body of a woman who had laboured under a bad purging for four months
before her death.
On it appear many very fmall hemifpheres.
FIGURE VII. PLATE I.
Reprefents a portion of the lower part of the ileum, taken out of the body (Part.I. Ch. I*
§ 5. p. 7.) the glands eroded in three places.
FIGURE VIII PLATE I.
Reprefents the internal furface of a portion of the lower part of the ileum, taken out of
the fame body.
A B. A longitudinal eminence, formed by a fmall remaining portion of the mefen-
tery pufhing up part of the inteftine.
a, &c. Small holes in the valvular conniventes.
b, &c. Holes in the "part of the internal coat, neareft the mefentery.
c, A portion of the internal coat, furrounding a hole, raifed up by air blown
into the cellular fubftance.
FIGURE IX. PLATE III.
Reprefents the femi-lunar valves of the aorta, convex towards the ventricle, and almoft
fhutting up the pafTage, as they appeared on drawing afide the large portion of the
tricufpidal valve.
ABC. The three femi-lunar valves.
D. The large portion of the tricufpidal valve drawn afide.
EF G. The internal furface of the left ventricle.
H. The feptum cordis.
FIGURE X. PLATE III.
Reprefents the three femi-lunar valves, with the neighbouring parts of the left ventricle
and of the aorta, laid fully open to view.
A. The cavity of the aorta# b, The
EXPLICATION of the FIGURES.
B. The orifice of the right coronary artery.
C. Tho orifice of the left coronary artery.
D E. The internal furface of the left ventricle.
F. Part of the large portion of the tricufpidal valve.
G H K. The femi-lunar valves {landing at a diftance from the furface of the aorta,
and partly covered with fatty excrefcences.
H. One of the valves cut up to fhew the increafe in thicknefs, which is chiefly
at the lower part, and appears better at
L. A fmall portion of the valve k.
FIGURE XI. PLATE III.
Reprefents the external furface of a portion of the dura mater, taken from the upper and
anterior part of that membrane, and out of the body of the woman. (Part IV. Ch. I.
§2. p. 70.)
A B. A hollow formed by the upper fide of the longitudinal finus, finking down
between two eminences, occafioned by the two lower fides of that
finus being, after they had been cut afunder, drawn afide. Near that
hollow, and on either fide of it, is reprefented the uneven furface of a
difeafed portion of the dura mater ; that furface was not white or
(hining, but of a dark afh colour, and moiftened with pus ; the bound-
aries of it were in fome parts quite black.
C D. Two portions of the external lamina of the dura mater raifed up by blowing,
into the form of blifters. In each appear feveral apertures, at which,
on preffing the neighbouring parts, pus had ifiued. At an aperture in
each blifter, a briftle is made to enter, both of which, as air had before
done, found a paflage between two laminae.
E. A thin portion of the external lamina, pufhed up by one of the briftles,
which fhines through it.
F. The extremity of the other briftle, pafling out at an opening, (through
which both pus and air had palled) on the outfide of one of the fupe-
rior angles of the longitudinal finus, which is here cut acrofs. The
briftle, as it panes along, is reprefented fhining through feveral thin
portions of the external lamina.
Neither matter, nor air, nor either of thebriftles, found any paflage through
the internal lamina, which did not appear in one part thinner than in
another, or into the longitudinal finus.
A CATAL.
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